One century of healing currents into the brain from the scalp: From electroconvulsive therapy to repetitive transcranial magnetic stimulation for neuropsychiatric disorders
Author: Riccardo Di Iorio1, Simone Rossi2, Paolo M Rossini3
Affiliation:
1 Neurology Unit, Policlinic A. Gemelli Foundation IRCCS, Rome, Italy. Electronic address: r.diiorio@live.it.
2 Siena Brain Investigation and Neuromodulation Lab (Si-BIN Lab), Department of Medicine, Surgery and Neuroscience, Section of Neurology and Clinical Neurophysiology, Policlinico Le Scotte, University of Siena, Italy.
3 Department of Neuroscience & Neurorehabilitation, IRCCS San Raffaele-Pisana, Rome, Italy.
Conference/Journal: Clin Neurophysiol
Date published: 2021 Nov 11
Other:
Volume ID: 133 , Pages: 145-151 , Special Notes: doi: 10.1016/j.clinph.2021.10.014. , Word Count: 171
Electroconvulsive therapy (ECT) was applied for the first time in humans in 1938: after 80 years, it remains conceptually similar today except for modifications of the original protocol aimed to reduce adverse effects (as persistent memory deficits) without losing clinical efficacy. We illustrate the stages of development as well as ups and downs of ECT use in the last eighty years, and the impact that it still maintains for treatment of certain psychiatric conditions. Targeted, individualized and safe noninvasive neuromodulatory interventions are now possible for many neuropsychiatric disorders thanks to repetitive transcranial magnetic stimulation (rTMS) that injects currents in the brain through electromagnetic induction, powerful enough to depolarize cortical neurons and related networks. Although ECT and rTMS differ in basic concepts, mechanisms, tolerability, side effects and acceptability, and beyond their conceptual remoteness (ECT) or proximity (rTMS) to "precision medicine" approaches, the two brain stimulation techniques may be considered as complementary rather than competing in the current treatment of certain neuropsychiatric disorders.
Keywords: Brain stimulation; Depression; ECT; Neuropsychiatric disorders; rTMS.
PMID: 34864511 DOI: 10.1016/j.clinph.2021.10.014
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