Biomedical subjects
S Pridmore
Publications and source records attributed to S Pridmore.
Vomiting, burns, and irrational behaviour.
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Transcranial magnetic stimulation: experience, knowledge and attitudes of recipients.
OBJECTIVE: To examine the experience, knowledge and attitudes of recipients of transcranial magnetic stimulation (TMS) regarding the treatment. There have been no studies of patient views about TMS. METHOD: A 60-item survey was administered by telephone to persons with depressive illness who received TMS at Royal Hobart Hospital, Tasmania. RESULTS: Forty-eight patients were interviewed. About two-thirds also had a history of treatment with electroconvulsive therapy (ECT). Experience and opinions about TMS were generally very positive. Almost three-quarters of interviewees believed TMS had been helpful. The vast majority rated TMS as more acceptable than having, or the prospect of having, ECT. The majority would have TMS again and would recommend it to others. CONCLUSIONS: The mostly favourable experiences and attitudes reported by interviewees will be reassuring to patients, their families and treating health professionals when TMS is being considered.
Psychiatry has much to offer for chronic pain.
OBJECTIVE: The objective of this study was to make an argument in favour of the inclusion of psychiatrists on chronic pain clinic teams. METHOD: The argument takes the form of answers to four central questions: (i) does pain involve an emotional experience; (ii) do psychiatric disorders accompany chronic pain; (iii) can psychiatric disorders present as chronic pain; and (iv) which patients present to pain units, and what do we know of their personalities? RESULTS: The affirmative case was substantiated in respect of the first three questions. In examining the last question, evidence indicates that patients who present to chronic pain units frequently have personality features that make assessment and therapy difficult. CONCLUSIONS: Psychiatry is the field of medicine where practitioners have the most experience with emotional states and personality, and is the only field where they have specialized skills in the diagnosis and treatment of psychiatric disorders. Psychiatry has much to offer in chronic pain management and chronic pain management teams should include a psychiatrist. This conclusion has resourcing and training implications.
Clozapine rechallenge after myocarditis.
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Improvement in chronic pain with transcranial magnetic stimulation.
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Postexercise facilitation appears durable in normal subjects.
Transcranial magnetic stimulation (TMS) was used to study the postexercise facilitation of 11 normal subjects on eight occasions. Between individuals, there was almost a sixfold difference in facilitation. The greatest positive percentage change for any individual was 61%, and the greatest negative percentage change was 51%. The results suggest that facilitation is a durable individual characteristic of normal subjects. Serial studies may therefore be indicated in monitoring individuals suffering relapsing conditions.
A failure to find large visible effects of ECT-induced seizures on SPECT scans.
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Effect on the emotions of healthy individuals of slow repetitive transcranial magnetic stimulation applied to the prefrontal cortex.
UNLABELLED: Recent studies indicate that both slow and fast repetitive transcranial magnetic stimulation (rTMS) have a mood-elevating effect in major depressive episodes. The effect of slow rTMS on the emotions of healthy individuals has not been examined. METHODS: We studied the effects of slow rTMS applied to the left and right prefrontal cortex (PFC) of 18 healthy individuals. Active and sham stimulation was applied to both sides of all individuals. Stimulation was with a 9-cm figure-of-eight coil at the following parameters: 110% of motor threshold, 1 Hz, single train of 500 stimuli. Depression, happiness, irritability, and anxiety were measured before and 5, 30, and 240 min after stimulation using visual analogue scales. A sleep questionnaire was completed the morning after each stimulation session. A new method of providing sham was used. RESULTS: Slow rTMS applied to the PFC did not produce significant changes in the emotions of healthy individuals; nor was sleep influenced. DISCUSSION: In conclusion, slow rTMS at these parameters applied to the PFC does not produce significant changes in the emotions of healthy individuals.
Cosmetic surgery can alter the mental state findings.
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Transcranial magnetic stimulation applications and potential use in chronic pain: studies in waiting.
Transcranial magnetic stimulation (TMS) is a new technology which uses electromagnetic principles to produce small electrical currents in the cortex. Evidence indicates that TMS can produce plastic changes in the CNS which are observable at both the cellular and physiological levels. It is proposed that studies are justified to determine whether TMS can provide short-term or long-term relief in chronic pain.
Substitution of rapid transcranial magnetic stimulation treatments for electroconvulsive therapy treatments in a course of electroconvulsive therapy.
Our aim was to determine whether rTMS treatments could be substituted for ECT treatments in a course of ECT, 1) without loss of antidepressant effect, and 2) without increase in subjective side-effects. We used a randomized, single-blind, controlled study. Two streams were conducted. Stream 1 received non-dominant unilateral (UL) ECT only, treatments being given 3 times per week for 2 weeks. Stream 2 received a combination of treatments: one UL ECT on Day 1 and rTMS on the following 4 days, all repeated once, after a 2-day respite. Twenty-two patients were recruited and 11 were allocated to each stream. There was no evidence that the antidepressant effect of the ECT only stream was superior to that of the ECT plus rTMS stream. There was no increase in subjective side-effects in the ECT plus rTMS stream. On the contrary, this stream was accompanied by less side effects than the ECT only stream in this study. In conclusion, we have determined that it is possible to substitute rTMS treatments for ECT treatments in a course of ECT without loss of antidepressant effect or an increase in subjective side-effects, using the described parameters. It is possible that the combination of ECT plus rTMS will provide a means of avoiding some of the subjective side-effects encountered with the conventional course of ECT. Further studies are indicated.
A rhythmic tic in Tourette's syndrome.
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Dexamethasone suppression test reversal in rapid transcranial magnetic stimulation-treated depression.
OBJECTIVE: The aim of this paper is to report the effect of rapid transcranial magnetic stimulation (rTMS) on the mood and dexamethasone suppression test (DST) of a patient with major depressive disorder (DSM-IV). CLINICAL PICTURE: A 36-year-old woman with a past history of prolactinoma and recurrent major depressive disorder presented with major depression on three separate occasions over a 3-month period. DST was positive on each occasion. TREATMENT: During each episode, a course of rTMS was given. Courses varied from seven to 13 once-daily treatment sessions depending on clinical response. These treatment sessions were 20 trains of 10 Hz for 5 s at 100% of motor threshold. OUTCOME: Remission was achieved, psychiatric rating scales improved and the DST status converted from positive to negative. There were no side effects. CONCLUSION: DST status in major depressive disorder can be converted from positive to negative by rTMS. This so far unreported observation increases our knowledge of rTMS.
Rapid transcranial magnetic stimulation and normalization of the dexamethasone suppression test.
Non-suppression of post-dexamethasone cortisol is a feature of endogenous/melancholic depression. Normalization of the dexamethasone suppresion test (DST) response is a feature of remission and antidepressant treatment. Twelve consecutive depressed non-suppressers were treated with rapid transcranial magnetic stimulation (rTMS). Six demonstrated normalization and good clinical improvement which was sustained for at least 1 month. Thus, rTMS has some biological effects in common with other antidepressant treatments.
Transcranial magnetic stimulation in the treatment of psychiatric disorders.
Transcranial magnetic stimulation (TMS) is a new technology that applies the principles of electromagnetism to deliver an electrical field to the cerebral cortices. Well established in diagnostic electrophysiology, TMS is now being studied as a treatment for psychiatric disorders. Evidence suggests this technique is safe and acceptable to patients. The future may see the application of TMS in obsessive-compulsive disorder, post-traumatic stress disorder and mania. There is strong evidence that it will become an accepted treatment of depression.
Supraorbital and d'Elia electrode positions in unilateral ECT?
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Longer than expected course of transcranial magnetic stimulation.
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