Technologies


Transcranial Magnetic Stimulation (TMS)


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Transcranial magnetic stimulation (TMS) is a noninvasive neuromodulation method that uses an insulated electromagnetic coil placed over the scalp to stimulate small regions of the brain.  The coil is connected to a pulse generator that delivers electrical current to the coil.  The strength of the pulses generated usually are of the same magnitude as those utilized by magnetic resonance imaging (MRI) machines. The coil generates brief magnetic pulses that produce small electrical currents in the brain just under the coil via electromagnetic induction.  

TMS can be used as a diagnostic test to examine connection between the brain and muscles as part of the evaluation for stroke or other injuries, multiple sclerosis, motor neuron disease (i.e., amyotrophic lateral sclerosis or ALS), and movement disorders (i.e., Parkinson’s Disease). 

TMS also can be used for the treatment of neuropsychiatric illnesses.  Single-pulse TMS has been approved by the FDA for the treatment of migraine.  When pulses are administered in rapid succession, it is referred to as “repetitive TMS” (rTMS) and can produce sustained changes in brain function and neuroplasticity, which may treat a variety of illnesses.  rTMS is approved for use by the FDA in treatment-resistant Major Depressive Disorder.  Evidence suggests that rTMS also may be useful for treatment of anxiety disorders, neuropathic pain, negative symptoms of schizophrenia, auditory hallucinations, tinnitus, and loss of function caused by stroke.  

Single- or repetitive pulse TMS also can be used as a research tool to examine cognitive or emotional processing during tasks.  Depending upon the location of pulse delivery and the timing of pulse administration during stimulus presentation of processing, TMS can be used to create a “virtual lesion” in processing pathways that can enhance or degrade task performance and facilitate examination of different components of task performance. 

TMS generally is well tolerated and has a favorable safety profile.  The most common adverse event reported during TMS is discomfort or pain at the site of stimulation.  Less common adverse events are the rare occurrence of induced seizures.  Other uncommon adverse effects of TMS include transient induction of hypomania, transient cognitive changes, transient hearing loss, transient impairment of working memory, and induced currents in electrical circuits in implanted devices. 


TMS Researchers


Ian A. Cook, M.D.

Psychiatrist and professor at UCLA, Semel Institute for Neuroscience and Human Behavior.

Aimee M. Hunter, Ph.D.

Research psychologist and is Associate Director of the Laboratory of Brain, Behavior, and Pharmacology at UCLA.

Andrew Leuchter, M.D.

Professor in the Department of Psychiatry and Biobehavioral Science at the University of California, Los Angeles (UCLA) Semel Institute for Neuroscience and Human Behavior at UCLA.

David Krantz, M.D., Ph.D.

Assistant Professor in Residence in the Department of Psychiatry and Biobehavioral Sciences at the David Geffen School of Medicine at UCLA.

Nanthia Suthana, Ph.D.

Assistant Professor in the Department of Neurosurgery at UCLA.
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Transcranial Direct Current Stimulation (tDCS)

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DCS is a non-invasive form of neuromodulation that delivers constant, low current stimulation to brain areas of interest via electrodes on the scalp. It is also easy to administer and the equipment is easily portable. Current is passed between two electrodes, one on the head and the second either on the head or an extracranial location such as the shoulder or arm. The anodal

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(negative) electrode generally is thought to be excitatory of underlying neuronal activity, while cathodal (positive) stimulation generally is thought to be inhibitory of underlying neuronal activity. It is the current passed between the two electrodes that modulates neuronal activity, although because both electrodes are active, it may be difficult to determine whether one or both electrode(s) is/are responsible for the effects observed.
tDCS was originally developed as a method to increase neuroplasticity and aid functional recovery in patients with brain injuries such as strokes. In healthy individuals, tDCS has been demonstrated to increase attention and concentration, language skills, mathematical ability, problem solving, memory, learning of visuospatial tasks, motor coordination, and

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cognitive performance on a variety of other tasks.

Research suggests that tDCS may be a valuable tool for the treatment of neuropsychiatric conditions such as depression, anxiety, Parkinson’s disease, and chronic pain, although currently it is not an FDA-approved treatment for any illness.

tDCS is considered to be a non-significant risk device for intermittent use, with minor adverse events including skin irritation or phosphenes (brief flash of light) at the onset of stimulation if an electrode is placed near the eye. Other adverse events include nausea, headache, dizziness, and itching under the electrode. Nausea most commonly occurs when the electrodes are placed above the mastoid process, thought to occur because of stimulation of the vestibular system. The long-term safety of repeated sessions of stimulation has not been systematically examined.

 


tDCS Researchers


Marco Iacoboni, M.D., Ph.D.

Professor of Psychiatry and Biobehavioral Sciences and Director of the Transcranial Magnetic Stimulation Lab at the Ahmanson-Lovelace Brain Mapping Center of the David Geffen School of Medicine at UCLA.

Allan Wu, M.D.

Assistant Professor in the UCLA Division of Movement Disorders and Associate Director of the Ahmanson-Lovelace Brain Mapping Center TMS Laboratory.
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Electroencephalography (EEG)

Electroencephalography (EEG) is a non-invasive and harmless method to record electrical activity of the brain from the use of small flat electrodes placed upon the scalp. EEG measures voltage fluctuations due to natural flow of ions within neurons of the brain. EEG can be used to diagnose epilepsy and localize seizures for possible surgical removal of damaged brain regions. EEG is also used to determine states of awareness (e.g. coma or brain death), measure sleep stages and diagnose sleeping disorders.
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Functional Magnetic Resonance Imaging (fMRI)

Functional magnetic resonance imaging or functional MRI (fMRI) is a functional neuroimaging procedure using MRI technology that measures brain activity by detecting associated changes in blood flow.
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fMRI Researchers


Marco Iacoboni, M.D., Ph.D.

Professor of Psychiatry and Biobehavioral Sciences and Director of the Transcranial Magnetic Stimulation Lab at the Ahmanson-Lovelace Brain Mapping Center of the David Geffen School of Medicine at UCLA.

Nanthia Suthana, Ph.D.

Assistant Professor in the Department of Neurosurgery at UCLA.

Allan Wu, M.D.

Assistant Professor in the UCLA Division of Movement Disorders and Associate Director of the Ahmanson-Lovelace Brain Mapping Center TMS Laboratory.
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Brain–computer interface (BCI)

A brain-computer interface (BCI), also known as a brain-machine interface, is a system that allows a person to control a computer or other electronic device using only his or her brain activity, with no movement required. BCI systems can be invasive through the use of implanted devices within the brain or non-invasive through the use of EEG. BCIs are applied in order to assist or repair human cognitive or sensory-motor functions.
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Trigeminal Nerve Stimulation (TNS)

Trigeminal nerve stimulation (TNS) is a non-invasive method of neuromodulation in which mild electrical signals stimulate branches of the trigeminal nerve (the largest cranial nerve) in order to modulate the activity of targeted brain regions. TNS differs from Transcranial Direct Current Stimulation (tDCS) in that the electrical energy is conducted directly into the brain through stimulation of a specific nerve. The trigeminal nerve provides input to the nucleus solitarius, the locus coeruleus, and the anterior cingulate cortex. These brain areas in which TNS modulates brain function areas are known to play key roles in regulation of mood and seizure seizure inhibition and initiation.

In TNS, the trigeminal nerve, the patient wears an external stimulator powered by a small battery that is connected to wires to conductive pads attached to the forehead. The electrodes transmit electrical stimulation to the branch of the trigeminal nerve in the forehead, which extends from the brain out into the skin of the face. Treatment usually is administered while the patient sleeps with the electrodes on for eight hours at night.

Early published results indicate that TNS has demonstrated benefits in treating adults with Major Depressive Disorder, medication-resistant epilepsy, Attention Deficit Hyperactivity Disorder (ADHD), and Post-traumatic Stress Disorder (PTSD). Studies showed that TNS is associated with significant improvements in mood, sleep, and attention. Larger controlled clinical trials are currently in progress for epilepsy, depression, PTSD, and ADHD.

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Deep Brain Stimulation (DBS)

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Deep brain stimulation is a neurmodulation technique where implanted electrodes can deliver electrical stimulation to a specific brain target. DBS is FDA approved for treatment of Parkinson’s disease, essential tremor, dystonia, and chronic and severe obsessive-compulsive disorder. Recently, clinical trials are exploring the efficacy of DBS for treatment of depression and Alzheimer’s disease. Stimulation is controlled by a pacemaker like device implanted under the skin usually in the chest that is connected through a wire to the DBS electrode. Delivery of electrical impulses with DBS electrodes can affect underlying neuronal tissue through temporary disruption or enhancement of endogenous activity. Various frequencies and protocols of DBS stimulation can be used and adjusted according to the patient and specific disorder being treated. 

DBS Researchers


Itzhak Fried, M.D.

Professor In Residence and Director of the Epilepsy Surgery Program

Dejan Markovic, Ph.D.

Assistant Professor of Electrical Engineering at UCLA

Nader Pouratian, M.D.

Assistant Professor Department of Neurosurgery

Nanthia Suthana, Ph.D.

Assistant Professor in the Department of Neurosurgery at UCLA.
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Transcranial Alternating Current Stimulation (tACS)

Transcranial alternating current stimulation (tACS) is a noninvasive means by which alternating currents applied through the skull over the occipital cortex of the brain entrains in a frequency-specific fashion the neural oscillations of the underlying brain.

tACS Researchers


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Synchronized Transcranial Magnetic Stimulation (sTMS)

Synchronized Transcranial Magnetic Stimulation (TMS)customarily uses high-field electromagnets to achieve therapeutic efficacy in Major Depressive Disorder (MDD). Low-field magnetic stimulation also may be useful for treatment of MDD, with fewer treatment-emergent adverse events. 

sTMS Researchers


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Electrocortical Stimulation

EElectrocortical StimulationElectrocortical stimulation mapping is regarded as the gold standard of intraoperative mapping for predicting functional outcomes. Nevertheless, methodologies across institutions are inconsistent. 

Electrocortical Stimulation Researchers


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Repetitive Transcranial Magnetic Stimulation

ERepetitive transcranial magnetic stimulation (rTMS) is a form of brain stimulation therapy. It uses magnetic pulses instead of electricity to activate parts of the brain.


Repetitive Transcranial Magnetic Stimulation Researchers


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