Neuromodulation Service
Director: Jonathan Becker, DO
Faculty:
Allyson Cundiff, MD
Christopher Maley, MD
William Petrie, MD
Elizabeth Shultz, DO
Neuromodulation is a treatment technique in which nerve cells are directly stimulated to create a therapeutic effect. The treatments are generally considered for patients who have not responded to medication. At Vanderbilt, we offer two neuromodulation treatments: transcranial magnetic stimulation (TMS) and electroconvulsive therapy (ECT).
- TMS is indicated for patients with Major Depressive Disorder who are in an acute depressive episode and who have not responded to treatment with at least one, often several, antidepressants. This treatment uses a magnet to generate a focalized electrical field which stimulates a part of the brain that is underactive in depression. It is well tolerated with only minor and transient side effects.
- ECT is one of the oldest but still the most effective treatment in psychiatry. It is indicated for a wide range of psychiatric illnesses including treatment-resistant Major Depressive Disorder, Bipolar Disorder, Schizoaffective Disorder, and Catatonia. This treatment involves the use of general anesthesia. While asleep, we use a small electrical current to elicit a medically managed seizure that allows the brain to “reset” and to restore brain functions that are disrupted with acute mental illness. This treatment may be associated with temporary memory loss which resolves within a few weeks.
Literature
- Becker JE, Maley CT, Shultz EKB, Peters TE. Neuromodulation: Past, Present, and Future. Child Adolesc Psychiatr Clin N Am. 2019 Jan;28(1):xi-xii.
- Maley CT, Becker JE, Shultz EKB. Electroconvulsive Therapy and Other Neuromodulation Techniques for the Treatment of Psychosis. Child Adolesc Psychiatr Clin N Am. 2019 Jan;28(1):91-100.
- Becker JE, Shultz EKB, Maley CT. Transcranial Magnetic Stimulation in Conditions Other than Major Depressive Disorder. Child Adolesc Psychiatr Clin N Am. 2019 Jan;28(1):45-52.