Psychiatric Neurotherapeutics

Description:

This volume covers the gamut of surgical and device-based treatments for psychiatric disorders. Written by experts in the field, this book covers neuroscience advances in the neurobiological underpinnings of psychiatric diseases, emerging surgical and device-based treatments, and advances in the field. Topics include electroconvulsive therapy, transcranial magnetic stimulation, Vagus nerve stimulation (VNS), and many other cutting-edge treatments and techniques. Psychiatric Neurotherapeutics is a valuable resource for psychiatrists, neurosurgeons, neurologists, researchers, and all other medical professionals interested in surgical and device-based treatments of psychiatric disorders.

Table of Contents:

1: Depression: Current Conceptual Trends

1. 1 Introduction

1. 2 Genetics of Depression

1. 3 Stress and Depression

1. 4 Emotion Regulation

1. 5 Functional Neuroanatomy of Depression

1. 6 The Anterior versus Lateral Network: Two Complementary Modes

1. 7 The Impasse in Mood Disorder Research: The Need for a Paradigm Shift

1. 8 Current Paradigm and Its Limitations

1. 9 Possible Options for the Future

1. 10 Final Discussion

References

2: Obsessive-Compulsive Disorder

2. 1 Clinical Features

2.

1. 1 Prevalence

2.

1. 2 Age of Onset

2.

1. 3 Gender

2.

1. 4 Race and Cultural Factors

2.

1. 5 Risk Factors

2.

1. 6 Genetic Factors

2. 2 Assessment

2. 3 Treatment Algorithms

2.

3. 1 Prognosis

2. 4 Clinician/Consumer Resources

References

3: Neuroimaging and Neurocircuitry of Obsessive-Compulsive Disorder and Major Depressive Disorder

3. 1 Introduction

3. 2 Obsessive-Compulsive Disorder

3.

2. 1 Background

3.

2. 2 Functional Anatomy

3.

2. 3 Cortico-Striato-Thalamo-Cortical Pathways

3.

2. 4 The Corticostriatal Hypothesis of OCD

3.

2. 5 Structural Imaging in OCD

3.

2. 6 Recent Developments in OCD Neurocircuitry

3.

2. 7 Conclusions

3. 3 Major Depressive Disorder

3.

3. 1 Background

3.

3. 2 The Neural Substrates of Mood Disorders

3.

3. 3 Limbic Structures

3.

3. 4 Prefrontal Cortex

3.

3.

4. 1 Orbital and Medial Prefrontal Cortex

3.

3.

4. 2 Orbital Prefrontal Network

3.

3.

4. 3 Medial Prefrontal Network

3.

3.

4. 4 Lateral Prefrontal Cortex

3.

3. 5 Cortico-Striato-Thalamo-Cortical Pathways

3.

3. 6 Clinical Evidence from Studies of Mood Disorders

3.

3.

6. 1 Limbic System

3.

3.

6. 2 Prefrontal Cortex

3.

3.

6. 3 Other Subcortical Structures

3.

3. 7 Conclusions

References

4: Electroconvulsive Therapy

4. 1 Indications

4. 2 Predictors of Response

4. 3 Contraindications

4. 4 Adverse Effects

4. 5 Maintenance ECT

4. 6 Mechanisms of Action of ECT

4. 7 Clinical Application of ECT

4.

7. 1 ECT Technique

4.

7. 2 Interaction with Medications

4.

7. 3 Informed Consent

4.

7. 4 New Directions

4. 8 Summary

References

5: Vagus Nerve Stimulation (VNS)

5. 1 Introduction

5. 2 History and Evidence

5.

2. 1 Mood Changes in Epilepsy Studies

5.

2. 2 Open-Label Studies in TRD

5.

2. 3 Results from the RCT of VNS in TRD

5.

2. 4 Longer-Term Outcomes with VNS versus Treatment as Usual

5.

2. 5 FDA Approval of VNS for TRD

5. 3 VNS Basics

5.

3. 1 Vagus Nerve Anatomy

5.

3. 2 Mechanism of Action in Depression

5.

3. 3 VNS Device Surgery

5. 4 Managing Patients with VNS in the Office

5.

4. 1 VNS Device Programming

5.

4.

1. 1 Candidates for Therapy

5.

4.

1. 2 General Precautions and Contraindications

5.

4. 2 Dosing Parameters

5. 5 VNS Effectiveness in Clinical Practice Post: FDA Approval

5. 6 Safety and Tolerability

5.

6. 1 Surgery Complications

5.

6. 2 Side Effects Related to Stimulation

5.

6. 3 Psychiatric Adverse Events

5.

6. 4 Adherence to Treatment

5. 7 Summary

References

6: Neurosurgical Ablative Procedures for Psychiatric Disorders

6. 1 Introduction

6. 2 Historical Perspective

6. 3 Neurocircuitry of MDD/OCD

6. 4 General Caveats of the Literature

6. 5 Anterior Cingulotomy

6.

5. 1 Efficacy of Anterior Cingulotomy

6.

5. 2 Adverse Effects of Anterior Cingulotomy

6. 6 Anterior Capsulotomy

6.

6. 1 Efficacy of Anterior Capsulotomy

6.

6. 2 Adverse Effects of Anterior Capsulotomy

6. 7 Subcaudate Tractotomy

6.

7. 1 Efficacy of Subcaudate Tractotomy

6.

7. 2 Adverse Effects of Subcaudate Tractotomy

6. 8 Limbic Leucotomy

6.

8. 1 Efficacy of Limbic Leucotomy

6.

8. 2 Adverse Effects of Limbic Leucotomy

6. 9 Mechanism of Action

6. 10 Future Directions

References

7: Deep Brain Stimulation for Obsessive-Compulsive Disorder and Major Depressive Disorder

7. 1 Introduction

7. 2 History of Deep Brain Stimulation

7. 3 Scientific Context

7. 4 Procedures and Practices

7. 5 Neuromodulation

7. 6 Deep Brain Stimulation of OCD Patients and Circuits

7.

6. 1 Clinical Outcomes

7. 7 Deep Brain Stimulation of MDD Patients and Circuits

7.

7. 1 Clinical Outcomes

7. 8 Cognition

7. 9 Neuroimaging

7. 10 Conclusion and Future Directions

References

8: Transcranial Magnetic Stimulation

8. 1 Introduction

8. 2 TMS Principles

8. 3 TMS Parameters

8. 4 TMS Safety

8. 5 TMS Clinical Applications: Major Depressive Disorder

8.

5. 1 Pivotal Trial

8.

5. 2 Naturalistic Studies

8.

5. 3 Durability and Maintenance

8.

5. 4 Predictors of Response

8.

5. 5 H-Coil Deep TMS

8. 6 Summary

References

9: Ablative Neurotherapeutics and Deep Brain Stimulation in Animal Models of Psychiatric Disorder

9. 1 Introduction

9. 2 PD: A Psychiatric Disorder? Non-motor Symptoms and Lesions or DBS

9.

2. 1 Globus Pallidus Interna/Entopeduncular Nucleus

9.

2. 2 Subthalamic Nucleus

9.

2.

2. 1 Subthalamic Nucleus Lesions

9.

2.

2. 2 Subthalamic Nucleus DBS

9. 3 OCD: Impulse Control Disorder

9.

3. 1 Repeated Behavior as an Index of Compulsion

9.

3.

1. 1 Nucleus Accumbens Manipulations on Various Forms of Repeated Behavior

9.

3.

1. 2 Subthalamic Nucleus Manipulations on Various Forms of Repeated Behavior

9.

3. 2 Control of Inhibition

9.

3.

2. 1 Nucleus Accumbens

9.

3.

2. 2 Subthalamic Nucleus

9. 4 Anxiety-Depression

9. 5 Addiction

9.

5. 1 Nucleus Accumbens

9.

5. 2 Lateral Habenula, Lateral Hypothalamus, and Prefrontal Cortex

9.

5. 3 STN

9.

5.

3. 1 STN: A Possible Target

9.

5.

3. 2 STN DBS: The Possible Strategy

9. 6 Conclusion

References

10: Future of Neurosurgery

10. 1 Introduction

10. 2 Understanding Circuits

10. 3 Modes of Delivery

10. 4 Future Applications

10. 5 Conclusions

References

Index

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