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Repetitive Transcranial Magnetic Stimulation
Transcranial magnetic stimulation (TMS) is a noninvasive neurostimulation technique in which a changing magnetic field is used to induce an electric current in a targeted area of the brain through electromagnetic induction. A device called a stimulator generates electric pulses that are delivered to a magnetic coil placed against the scalp. The resulting magnetic field penetrates the skull and induces a secondary electric current in the underlying brain tissue, modulating neural activity. Repetitive transcranial magnetic stimulation (rTMS) is a safe, effective, and FDA-approved treatment for major depressive disorder (approved in 2008), chronic pain (2013), and obsessive-compulsive disorder (2018). It has strong evidence for certain neurological and psychiatric conditions—especially depression (with a large effect size), neuropathic pain, and stroke recovery—and emerging advancements like iTBS and image-guided targeting may improve its efficacy and efficiency. Advers ...
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Psychiatry
Psychiatry is the medical specialty devoted to the diagnosis, treatment, and prevention of deleterious mental disorder, mental conditions. These include matters related to cognition, perceptions, Mood (psychology), mood, emotion, and behavior. Initial psychiatric assessment of a person begins with creating a Medical history, case history and conducting a mental status examination. Laboratory tests, physical examinations, and psychological tests may be conducted. On occasion, neuroimaging or neurophysiological studies are performed. Mental disorders are diagnosed in accordance with diagnostic manuals such as the ''International Classification of Diseases'' (ICD), edited by the World Health Organization (WHO), and the ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM), published by the American Psychiatric Association (APA). The fifth edition of the DSM (DSM-5) was published in May 2013. Treatment may include psychotropics (psychiatric medicines), psychotherapy, su ...
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Effect Size
In statistics, an effect size is a value measuring the strength of the relationship between two variables in a population, or a sample-based estimate of that quantity. It can refer to the value of a statistic calculated from a sample of data, the value of one parameter for a hypothetical population, or to the equation that operationalizes how statistics or parameters lead to the effect size value. Examples of effect sizes include the correlation between two variables, the regression coefficient in a regression, the mean difference, or the risk of a particular event (such as a heart attack) happening. Effect sizes are a complement tool for statistical hypothesis testing, and play an important role in power analyses to assess the sample size required for new experiments. Effect size are fundamental in meta-analyses which aim to provide the combined effect size based on data from multiple studies. The cluster of data-analysis methods concerning effect sizes is referred to as estima ...
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Amyotrophic Lateral Sclerosis
Amyotrophic lateral sclerosis (ALS), also known as motor neuron disease (MND) or—in the United States—Lou Gehrig's disease (LGD), is a rare, Terminal illness, terminal neurodegenerative disease, neurodegenerative disorder that results in the progressive loss of both upper and lower motor neurons that normally control Skeletal muscle, voluntary muscle contraction. ALS is the most common form of the motor neuron diseases. ALS often presents in its early stages with gradual muscle Spasticity, stiffness, Fasciculation, twitches, Muscle weakness, weakness, and Muscle atrophy, wasting. Motor neuron loss typically continues until the abilities to eat, speak, move, and, lastly, breathe are all lost. While only 15% of people with ALS also fully develop frontotemporal dementia, an estimated 50% face at least some minor difficulties with cognitive disorder, thinking and behavior. Depending on which of the aforementioned symptoms develops first, ALS is classified as ''limb-onset'' (b ...
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Myelopathy
Myelopathy describes any neurologic deficit related to the spinal cord. When due to trauma, myelopathy is known as (acute) spinal cord injury. When inflammatory, it is known as myelitis. Disease that is vascular in nature is known as vascular myelopathy. The most common form of myelopathy in humans, cervical spondylotic myelopathy (CSM) also called ''degenerative cervical myelopathy'', results from narrowing of the spinal canal ( spinal stenosis) ultimately causing compression of the spinal cord. In Asian populations, spinal cord compression often occurs due to a different, inflammatory process affecting the posterior longitudinal ligament. Presentation Clinical signs and symptoms depend on which spinal cord level (cervical, thoracic, or lumbar) is affected and the extent (anterior, posterior, or lateral) of the pathology, and may include: * Upper motor neuron signs—weakness, spasticity, clumsiness, altered tonus, hyperreflexia and pathological reflexes, including Hof ...
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Peripheral Nervous System
The peripheral nervous system (PNS) is one of two components that make up the nervous system of Bilateria, bilateral animals, with the other part being the central nervous system (CNS). The PNS consists of nerves and ganglia, which lie outside the brain and the spinal cord. The main function of the PNS is to connect the CNS to the Limb (anatomy), limbs and Organ (anatomy), organs, essentially serving as a relay between the brain and spinal cord and the rest of the body. Unlike the CNS, the PNS is not protected by the vertebral column and skull, or by the blood–brain barrier, which leaves it exposed to toxins. The peripheral nervous system can be divided into a somatic nervous system, somatic division and an autonomic nervous system, autonomic division. Each of these can further be differentiated into a sensory and a motor sector. In the somatic nervous system, the cranial nerves are part of the PNS with the exceptions of the olfactory nerve and epithelia and the optic nerve (c ...
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Central Nervous System
The central nervous system (CNS) is the part of the nervous system consisting primarily of the brain, spinal cord and retina. The CNS is so named because the brain integrates the received information and coordinates and influences the activity of all parts of the bodies of bilateria, bilaterally symmetric and triploblastic animals—that is, all multicellular animals except sponges and Coelenterata, diploblasts. It is a structure composed of nervous tissue positioned along the Anatomical_terms_of_location#Rostral,_cranial,_and_caudal, rostral (nose end) to caudal (tail end) axis of the body and may have an enlarged section at the rostral end which is a brain. Only arthropods, cephalopods and vertebrates have a true brain, though precursor structures exist in onychophorans, gastropods and lancelets. The rest of this article exclusively discusses the vertebrate central nervous system, which is radically distinct from all other animals. Overview In vertebrates, the brain and spinal ...
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Primary Motor Cortex
The primary motor cortex ( Brodmann area 4) is a brain region that in humans is located in the dorsal portion of the frontal lobe. It is the primary region of the motor system and works in association with other motor areas including premotor cortex, the supplementary motor area, posterior parietal cortex, and several subcortical brain regions, to plan and execute voluntary movements. Primary motor cortex is defined anatomically as the region of cortex that contains large neurons known as Betz cells, which, along with other cortical neurons, send long axons down the spinal cord to synapse onto the interneuron circuitry of the spinal cord and also directly onto the alpha motor neurons in the spinal cord which connect to the muscles. At the primary motor cortex, motor representation is orderly arranged (in an inverted fashion) from the toe (at the top of the cerebral hemisphere) to mouth (at the bottom) along a fold in the cortex called the central sulcus. However, some body p ...
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Transcranial Direct-current Stimulation
Transcranial direct current stimulation (tDCS) is a form of neuromodulation that uses constant, low direct current delivered via electrodes on the head. This type of neurotherapy was originally developed to help patients with brain injuries or neuropsychiatric conditions such as major depressive disorder. It can be contrasted with cranial electrotherapy stimulation, which generally uses alternating current the same way, as well as transcranial magnetic stimulation. Research shows increasing evidence for tDCS as a treatment for depression. There is mixed evidence about whether tDCS is useful for cognitive enhancement in healthy people. There is no strong evidence that tDCS is useful for memory deficits in Parkinson's disease and Alzheimer's disease, non-neuropathic pain, nor for improving arm or leg functioning and muscle strength in people recovering from a stroke. There is emerging supportive evidence for tDCS in the management of schizophreniaespecially for negative symptoms. ...
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List Of Veterans Affairs Medical Facilities
Veterans' health care in the United States is separated geographically into 19 regions (numbered 1, 2, 4–10, 12 and 15–23)In January 2002, the Veterans Health Administration announced the merger of VISNs 13 and 14 to create a new, combined network, VISN 23''Transition Watch'', Vol. 5, No 3, May 2002, p.3. known as VISNs, or Veterans Integrated Service Networks, into systems within each network headed by medical centers, and hierarchically within each system by division level of care or type. This article lists VA VISN facilities by region, location, and type. VA medical facilities and Vet Centers are run by the Veterans Health Administration of the United States Department of Veterans Affairs. Vet Centers focus on post-war adjustment, counseling and outreach services for veterans and their families. There are currently 170 VA Medical Centers and approximately 1,193 community-based outpatient clinics in the US. Facilities types (level of care types) are listed in the VISN tabl ...
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National Institute For Health And Care Excellence
The National Institute for Health and Care Excellence (NICE) is an executive non-departmental public body of the Department of Health and Social Care (United Kingdom), Department of Health and Social Care. As the national health technology assessment body of England, it is responsible for judging the cost-effectiveness of medicines and making them available on the NHS through reimbursement, with its judgements informing decisions in Wales and Northern Ireland. It also provides a range of clinical guidance to the NHS in England and Wales, which are considered by Northern Ireland. History Organisational history It was set up as the National Institute for Clinical Excellence in 1999, and on 1 April 2005 joined with the Health Development Agency to become the new National Institute for Health and Clinical Excellence (still abbreviated as NICE). Following the Health and Social Care Act 2012, NICE was renamed the National Institute for Health and Care Excellence on 1 April ...
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Epileptic Seizure
A seizure is a sudden, brief disruption of brain activity caused by abnormal, excessive, or synchronous neuronal firing. Depending on the regions of the brain involved, seizures can lead to changes in movement, sensation, behavior, awareness, or consciousness. Symptoms vary widely. Some seizures involve subtle changes, such as brief lapses in attention or awareness (as seen in absence seizures), while others cause generalized convulsions with loss of consciousness ( tonic–clonic seizures). Most seizures last less than two minutes and are followed by a postictal period of confusion, fatigue, or other symptoms. A seizure lasting longer than five minutes is a medical emergency known as status epilepticus. Seizures are classified as provoked, when triggered by a known cause such as fever, head trauma, or metabolic imbalance, or unprovoked, when no immediate trigger is identified. Recurrent unprovoked seizures define the neurological condition epilepsy. Clinical features Seizure ...
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