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Research ArticlePERSPECTIVES IN PHARMACOLOGY

Brain Stimulation for Neurological and Psychiatric Disorders, Current Status and Future Direction

Jing-Yu Chang
Journal of Pharmacology and Experimental Therapeutics April 2004, 309 (1) 1-7; DOI: https://doi.org/10.1124/jpet.103.049718
Jing-Yu Chang
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Abstract

Interest in brain stimulation therapies has been rejuvenated over the last decade and brain stimulation therapy has become an alternative treatment for many neurological and psychiatric disorders, including Parkinson's disease (PD), dystonia, pain, epilepsy, depression, and schizophrenia. The effects of brain stimulation on PD are well described, and this treatment has been widely used for such conditions worldwide. Treatments for other conditions are still in experimental stages and large-scale, well controlled studies are needed to refine the treatment procedures. In the treatment of intractable brain disorders, brain stimulation, especially transcranial magnetic stimulation (TMS), is an attractive alternative to surgical lesioning as it is relatively safe, reversible, and flexible. Brain stimulation, delivered either via deeply implanted electrodes or from a surface-mounted transcranial magnetic device, can alter abnormal neural circuits underlying brain disorders. The neural mechanisms mediating the beneficial effects of brain stimulation, however, are poorly understood. Conflicting theories and experimental data have been presented. It seems that the action of stimulation on brain circuitry is not limited to simple excitation or inhibition. Alterations of neural firing patterns and long-term effects on neurotransmitter and receptor systems may also play important roles in the therapeutic effects of brain stimulation. Future research on both the basic and clinical fronts will deepen our understanding of how brain stimulation works. Real-time computation of neural activity allows for integration of brain stimulation signals into ongoing neural processing. In this way abnormal circuit activity can be adjusted by optimal therapeutic brain stimulation paradigms.

Footnotes

  • This work was supported in part by National Institutes of Health Grants NS-43441 and NS-4582.

  • Article, publication date, and citation information can be found at http://jpet.aspetjournals.org.

  • DOI: 10.1124/jpet.103.049718.

  • ABBREVIATIONS: DBS, deep brain stimulation: DA, dopamine; PD, Parkinson's disease; STN, subthalamic nucleus; GPi, internal segment of globus pallidus; HFS, high-frequency stimulation; SNr, substantia nigra pars reticulata; CM, centromedian thalamus; TMS, transcranial magnetic stimulation; rTMS, rapid-rate TMS; CBF, cerebral blood flow.

    • Received September 3, 2003.
    • Accepted January 7, 2004.
  • The American Society for Pharmacology and Experimental Therapeutics
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Journal of Pharmacology and Experimental Therapeutics: 309 (1)
Journal of Pharmacology and Experimental Therapeutics
Vol. 309, Issue 1
1 Apr 2004
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Research ArticlePERSPECTIVES IN PHARMACOLOGY

Brain Stimulation for Neurological and Psychiatric Disorders, Current Status and Future Direction

Jing-Yu Chang
Journal of Pharmacology and Experimental Therapeutics April 1, 2004, 309 (1) 1-7; DOI: https://doi.org/10.1124/jpet.103.049718

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Research ArticlePERSPECTIVES IN PHARMACOLOGY

Brain Stimulation for Neurological and Psychiatric Disorders, Current Status and Future Direction

Jing-Yu Chang
Journal of Pharmacology and Experimental Therapeutics April 1, 2004, 309 (1) 1-7; DOI: https://doi.org/10.1124/jpet.103.049718
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