Cadwell easy eeg reader
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The primary differences between the sTMS device used in the study and a standard rTMS system, other than the delivery mechanism are the magnetic field waveform (i.e., sinusoidal vs pulsed) and the intensity of stimulation. This pilot study was designed to examine the feasibility of the technique, and an initial methodological validation of the possible efficacy of this new treatment modality. This device uses three neodymium permanent magnets that rotate at a programmed frequency or set of frequencies at or near the subject’s IAF, thereby imparting low energy stimulation broadly over the brain to entrain brain oscillations and potentially reset thalamocortical oscillators.
#Cadwell easy eeg reader trial#
We report here on the first pilot trial of an experimental device designed to administer low-energy sinusoidal waveform sTMS to patients suffering from MDD. By synchronizing TMS to the IAF, it may be possible to use a low magnetic field strength sinusoidal waveform applied broadly across the brain, in contrast to the focal high strength magnetic field pulses traditionally utilized. We hypothesized that it may be possible to improve the effectiveness of rTMS treatment for resetting cortical oscillators by synchronizing the rTMS pulses to the frequency of the patient’s individual alpha frequency (IAF), called synchronous TMS (sTMS). Stimulation variables that have not been systematically studied include stimulus intensity, frequency, and location. Questions remain, however, as to the optimal stimulation parameters to achieve this resetting of oscillators. Repetitive entrainment of endogenous oscillations to a 10 Hz frequency of stimulation may facilitate the reemergence of intrinsic cerebral rhythms, thereby restoring normal brain function. Evidence suggests that rTMS may achieve therapeutic effectiveness through resetting of thalamocortical oscillators. The immediate effect of rTMS pulses on brain function is the entrainment of cerebral oscillations to the frequency of stimulation.
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The mechanism of action of rTMS to achieve relief of depressive symptoms remains incompletely understood. The treatment paradigm was identical for all subjects, regardless of their symptoms or characteristics of brain function. In both studies, rTMS stimulation was administered at 120% of the motor threshold at a frequency of 10 Hz. The study by O’Reardon, and more recently in the OPT-TMS trial by George, showed that this technique is an effective treatment for MDD. Traditional repetitive Transcranial Magnetic Stimulation (rTMS) directs high field strength magnetic pulses to a single brain location, most commonly the dorsolateral prefrontal cortex (DLPFC), as a treatment for Major Depressive Disorder (MDD). These results suggest that sTMS may be an effective treatment for MDD.
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No significant side effects were reported. No significant difference was found between fixed and random groups (p = 0.30). Subjects with either fixed or random frequency active sTMS had statistically significantly greater percentage reduction in depression severity compared to sham (48.5% vs. 20 half-hour sTMS sessions were administered 5 days per week for 4 weeks. Subjects were randomized to three treatment groups: 1) active sTMS with a fixed frequency at the subject’s alpha frequency 2) active sTMS with a random stimulus frequency that varied between 8 Hz and 13 Hz and, 3) sham sTMS. Most subjects received concurrent antidepressant medications that remained unchanged during the study. Forty-six subjects were included in the final analysis. Methodįifty-two subjects with MDD were enrolled in a randomized, sham controlled, double-blind treatment study (Trial Registration: NCT01683019). We developed a device that rotates neodymium cylindrical magnets at three locations along the midline above the subject’s scalp to impart low-energy, sinusoidal-waveform magnetic brain stimulation over a broad area, and performed this efficacy study. We postulated that delivery of rTMS at the subject’s individual alpha frequency (synchronized TMS, or sTMS) would achieve efficacy with lower energy of stimulation. Repetitive Transcranial Magnetic Stimulation (rTMS) is an effective treatment for Major Depressive Disorder (MDD), and is based upon delivery of focal high-energy pulses of electromagnetic stimulation.