Transcranial magnetic stimulation and transcranial direct current stimulation appear to be safe neuromodulatory techniques useful in the treatment of anxiety disorders and other neuropsychiatric disorders

Abstract

Transcranial magnetic stimulation (TMS) has recently been investigated as a possible adjuvant treatment for many neuropsychiatric disorders, and has already been approved for the treatment of drug-resistant depression in the United States and in Brazil, among other countries. Although its use in other neuropsychiatric disorders is still largely experimental, many physicians have been using it as an off-label add-on therapy for various disorders. More recently, another technique, transcranial direct current stimulation (tDCS), has also become available as a much cheaper and portable alternative to TMS, although its mechanisms of action are different from those of TMS. The use of off-label therapeutic TMS or tDCS tends to occur in the setting of diseases that are notoriously resistant to other treatment modalities. Here we discuss the case of anxiety disorders, namely panic and post-traumatic stress disorders, highlighting the uncertainties and potential problems and benefits of the clinical use of these neuromodulatory techniques at the current stage of knowledge.

Neurostimulation Combined With Cognitive Intervention in Alzheimer’s Disease (NeuroAD): Study Protocol of Double-Blind, Randomized, Factorial Clinical Trial

“…Another key point is that most studies involving tDCS in AD typically assess neurostimulation effects on only one cortical area. This aspect is worrying because the pathological characterization of dementia differs from other neurological diseases, wherein only one brain region should be modulated such as stroke or depression (Iannone et al, 2016 ; Ilić et al, 2016 ). In AD, the clinical symptoms are not restricted to memory loss, suggesting the involvement of more complex neural networks (Lesuis et al, 2016 ; Ossenkoppele et al, 2016 ).…”

Transcranial direct current stimulation in mild cognitive impairment: methodology for a randomized controlled trial

“…The effects of electric currents upon neuronal function have been studied for decades (Priori, 2003). More recently, after several reports of beneficial effects of TMS upon symptoms of many neuropsychiatric disorders, such as depression (Pascual-Leone et al, 1996;Boechat-Barros, 2004;Boechat-Barros & Brasil-Neto, 2004;Leo & Latif, 2007;O'Reardon et al, 2007;Brunoni et al, 2010b;Holtzheimer & Mayberg, 2012;Rothwell, 2012;Iannone et al, 2016) and chronic pain (Nguyen et al, 1999;Leo & Latif, 2007;Rosen et al, 2009;Galhardoni et al, 2015) and neuropathic pain (Brown & Barbaro, 2003;Fagundes-Pereyra et al, 2010;Nguyen et al, 2011;Nizard et al, 2012), transcranial direct current stimulation (tDCS) has also been the subject of many studies due to its ability to modulate cortical function in a non-invasive manner. For that reason, there is a great deal of interest in its potential applications in the fields of neurology and psychiatry (Alonzo et al, 2012;Demirtas-Tatlidede, VahabzadehHagh & Pascual-Leone, 2013;Elder & Taylor, 2014;Flöel, 2014;Kuo, Paulus & Nitsche, 2014;Dedoncker et al, 2016;Iannone et al, 2016).…”

Transcranial direct current stimulation in mild cognitive impairment: methodology for a randomized controlled trial

“…More recently, after several reports of beneficial effects of TMS upon symptoms of many neuropsychiatric disorders, such as depression (Pascual-Leone et al, 1996;Boechat-Barros, 2004;Boechat-Barros & Brasil-Neto, 2004;Leo & Latif, 2007;O'Reardon et al, 2007;Brunoni et al, 2010b;Holtzheimer & Mayberg, 2012;Rothwell, 2012;Iannone et al, 2016) and chronic pain (Nguyen et al, 1999;Leo & Latif, 2007;Rosen et al, 2009;Galhardoni et al, 2015) and neuropathic pain (Brown & Barbaro, 2003;Fagundes-Pereyra et al, 2010;Nguyen et al, 2011;Nizard et al, 2012), transcranial direct current stimulation (tDCS) has also been the subject of many studies due to its ability to modulate cortical function in a non-invasive manner. For that reason, there is a great deal of interest in its potential applications in the fields of neurology and psychiatry (Alonzo et al, 2012;Demirtas-Tatlidede, Vahabzadeh-Hagh & Pascual-Leone, 2013;Elder & Taylor, 2014;Flöel, 2014;Kuo, Paulus & Nitsche, 2014;Dedoncker et al, 2016;Iannone et al, 2016). tDCS employs direct current to modulate neuronal excitability according to the polarity of stimulation: anodal stimulation has been found to increase neuronal excitability, whereas cathodal stimulation decreases excitability of the underlying cortical region (Javadi & Walsh, 2012).…”