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From SNE to Researcher in psychiatry From SNE to Researcher in psychiatry

03-31-2020 , 08:55 AM
From this week I'm sitting at home and trying to work distant [:
I think that's good time for imroving my language's skills (My level is B1). For example, I started to watch Westworld on English ))

I'm PhD student and junior researcher in Research centre of psychiatry in Moscow. I started my professional career in 2017. My primary scientific research is devoted to the problem of treatment-resistant depression (TRD). I'm currently writing a chapter for a book on transcarnial magnetic stimulation (TMS). TMS is approach, using for therapy in resistant depression. In next posts i will write about my main research in details. If you have any questions about my profession, about psychiatry, or Russia, or life in Russia You are welcome
From SNE to Researcher in psychiatry Quote
03-31-2020 , 11:01 PM
Will TMS become the standard brain stimulation therapy for depression? It seems much more patient friendly than ECT and almost as effective. It's hard to imagine why anyone would choose ECT over TMS unless their psychiatrist strongly advises it. Thoughts on the future of tDCS? Are there any studies comparing TMS and tDCS in the treatment of depression?

Last edited by gregorio; 03-31-2020 at 11:07 PM.
From SNE to Researcher in psychiatry Quote
04-01-2020 , 11:56 AM
Quote:
Originally Posted by gregorio
Will TMS become the standard brain stimulation therapy for depression? It seems much more patient friendly than ECT and almost as effective. It's hard to imagine why anyone would choose ECT over TMS unless their psychiatrist strongly advises it. Thoughts on the future of tDCS? Are there any studies comparing TMS and tDCS in the treatment of depression?
I suggest that yes. TMS is safety procedure and this approach in therapy of depression is being considered as method of treatment on 1st stage


Our old study (2008) of compare safety and effectiveness TMS vs ECT found that ECT more effective in TRD, but tolerability for TMS is better (of course )

We can use TMS for outpatients. Stimulation duration per session is 20-40 minutes for rTMS and depends from protocol of stimulation (in last years we are using protocol with next parametres - 20 Hz, 20 minutes, 15 sessions (3 weeks, 1 session per day) for course - that's more effective). We apply ECT only for inpatients, because we should supervise of statement patiens in 2 hours after procedure. ECT is performed using anesthesia.

TMS, unlike ECT, is performed without special premedication/anesthesia. Main side effects are headache and dizziness after TMS. The severity of side effects is usually insignificant.

About tDCS i'll say more in next posts. It's very perspective approach for treatment depression, especially with neuronavigation based on individual fMRI.
From SNE to Researcher in psychiatry Quote
04-03-2020 , 06:17 AM
Throughout April, I'll be working distantly because of coronavirus epidemic. That's really good news for me, now i have enough time to write big review of TMS in psychiatry for future book.

Well, what's about my common investigation?
We compare standart approach of TMS with neuronavigated, personified based on fMRI, method. In my study we use TMS in patients with TRD (defined loosely here as non-response to at least two adequate antidepressant trials). I will analyze:
1. Efficacy
2. Targets of stimulation (2 big subgroups in personified group)
3. Changes in functional connectivity (FC) pre-post personified TMS
4. Correlation beetween symptoms and changes in FC

In next posts:
1. Depression - theory of pathogenesis, ethiology (that's very important say before dicsussion about tDCS and deep TMS)
2. tDCS, TMS and deep TMS

Moreover, I will always be happy with new questions!
From SNE to Researcher in psychiatry Quote
04-10-2020 , 08:09 PM
In treatment resistant depression I think anti self-alienation measures can help. Reconnecting with oneself ... and therefore with life and with others. Mindfulness, self-compassion, approaching fears instead of avoiding them ... anything that walks back our ingrained deadening self-alienation.

The chemical factors involved I wouldn't know. I almost hesitate to say the simple and obvious ACTIVITY ... both physical and mental is a piece, as in physical exercise and mental work. The plying of our aptitudes is fundamental and usually enlivening.

Just some thoughts. But anything that walks back the numbing, deadening, impoverishing experience of self-alienation can be a useful tack.
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