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Transcranial magnetic stimulation: Difference between revisions

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*Disorders of consciousness (e.g., [[vegetative state]] or [[minimally conscious state]])
*[[Alzheimer's disease|Alzheimer’s disease]]
*Psychiatric diseases, such as [[Depression (mood)|depression]],<ref>{{Cite journal |last=Hernández-Sauret |first=Ana |last2=Martin de la Torre |first2=Ona |last3=Redolar-Ripoll |first3=Diego |date=2024-05-21 |title=Use of transcranial magnetic stimulation (TMS) for studying cognitive control in depressed patients: A systematic review |url=https://doi.org/10.3758/s13415-024-01193-w |journal=Cognitive, Affective, & Behavioral Neuroscience |language=en |doi=10.3758/s13415-024-01193-w |issn=1531-135X|doi-access=free }}</ref> [[Obsessive–compulsive disorder|obsessive compulsive disorder]], [[schizophrenia]], [[Anxiety disorder|anxiety]] and [[Tourette syndrome]]
 
== Adverse effects ==
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====Other neurological areas====
In the [[European Economic Area]], various versions of Deepdeep TMS H-coils have [[CE marking]] for
[[Alzheimer's disease]],<ref name=OCD/>
[[autism]],<ref name=OCD/>
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* In August 2012, the jurisdiction covering Arkansas, Louisiana, Mississippi, Colorado, Texas, Oklahoma, and New Mexico determined that there was insufficient evidence to cover the treatment,<ref>{{cite web |author=Novitas Solutions, Inc. |date=2013-12-04 |title=LCD L32752 – Transcranial Magnetic Stimulation for Depression |url=https://hwscenter.com/treatments/#neuropsychology |access-date=2014-02-17 |work=Contractor's Determination Number L32752 |publisher=[[Centers for Medicare and Medicaid Services]]}}</ref> but the same jurisdiction subsequently determined that Medicare would cover TMS for the treatment of depression after December 2013.<ref>{{cite web|url=http://www.cms.gov/medicare-coverage-database/details/lcd-details.aspx?LCDId=33660&ContrId=259&bc=IAAAAAgAAAAAAA%3d%3d&|title=LCD L33660 – Transcranial Magnetic Stimulation (TMS) for the Treatment of Depression|author=Novitas Solutions, Inc.|work=Contractor's Determination Number L33660|publisher= [[Centers for Medicare and Medicaid Services]]|date=2013-12-05|access-date=2014-02-17}}</ref>
* Subsequently,{{when|date=April 2021}} some other Medicare jurisdictions added Medicare coverage for depression.{{citation needed|date=April 2021}}<!-- By mid-2020, it was available in Illinois, to this editor. Acwilson9 -->
 
== Limitations ==
 
There are serious concerns about stimulating brain tissue using non-invasive magnetic field methods:
 
First, the uncertainty in the dose (time and technical field parameters) for correct and healthy stimulation is a complex and challenging issue.<ref>Benussi A, Pascual-Leone A, Borroni B (2020). "Non-Invasive Cerebellar Stimulation in Neurodegenerative Ataxia: A Literature Review". ''International Journal of Molecular Sciences.'' 21 (6): 1948. doi:10.3390/ijms21061948</ref> While neurophysiology lacks knowledge about the nature of such a treatment of nervous diseases at the cellular level,<ref>Rosa, MA; Lisanby, SH (2012). "Somatic treatments for mood disorders". ''Neuropsychopharmacology.'' 37 (1): 102–116. doi:10.1038/npp.2011.225</ref> this method involves excessive exposure of the brain to an intense field, which is several times and even orders of magnitude higher than natural electromagnetic fields in the brain.<ref>Grimaldi G, Argyropoulos GP, Boehringer A, Celnik P, Edwards MJ, Ferrucci R, et al. (2014). "Non-invasive cerebellar stimulation--a consensus paper" (PDF). ''Cerebellum.'' 13 (1): 121–138. doi:10.1007/s12311-013-0514-7</ref><ref>Siebner HR, Hartwigsen G, Kassuba T, Rothwell JC (2009). "How does transcranial magnetic stimulation modify neuronal activity in the brain? Implications for studies of cognition". ''Cortex; A Journal Devoted to the Study of the Nervous System and Behavior.'' 45 (9): 1035–1042. doi:10.1016/j.cortex.2009.02.007</ref>
 
Second, it is impossible to localize the effect of stimulation on specific neural networks that need to be treated.<ref name="Sparing and Mottaghy_2008">Sparing R, Mottaghy FM (2008). "Noninvasive brain stimulation with transcranial magnetic or direct current stimulation (TMS/tDCS)-From insights into human memory to therapy of its dysfunction". ''Methods.'' 44 (4): 329–337. doi:10.1016/j.ymeth.2007.02.001</ref>
Neuronal activity related to mental processes, neuronal correlates of cognitive functions are still intriguing questions for contemporary research. Non-invasive brain tissue stimulation targets a large area of poorly characterized tissue. An undefined dose and target of radiation can destroy healthy cells during a treatment procedure. Because it is unclear whether magnetic fields reach only those neural structures of the brain that need treatment, this uncertainty challenges the selection of treatment for neurological disorders by magnetic fields. Thus, magnetic field exposure may destroy healthy neuronal structures. The inability to localize the effect of stimulation makes it challenging to target stimulation only to the desired neural networks. <ref name="Sparing and Mottaghy_2008" />
 
== See also ==