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28 - Brain stimulation in the treatment of anxiety disorders

from Section 4 - Treatment of anxiety: current status and controversial issues

Published online by Cambridge University Press:  10 November 2010

By
Antonio Mantovani  and
Sarah H. Lisanby
Edited by
Helen Blair Simpson ,
Yuval Neria ,
Roberto Lewis-Fernández  and
Franklin Schneier
Helen Blair Simpson
Affiliation:
Columbia University, New York
Yuval Neria
Affiliation:
Columbia University, New York
Roberto Lewis-Fernández
Affiliation:
Columbia University, New York
Franklin Schneier
Affiliation:
Columbia University, New York
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Summary

Brain stimulation techniques include transcranial electrical approaches, magnetic approaches and surgical approaches. This chapter reviews research to date on these approaches in the treatment of anxiety disorders, discusses how this work may advance knowledge, and tests hypotheses about the neural circuitry underlying anxiety disorders. Case reports suggest that electroconvulsive therapy (ECT) might be helpful in the treatment of refractory obsessive-compulsive disorder (OCD) as well. Transcranial magnetic stimulation (TMS) was recently approved by the US Food and Drug Administration (FDA) for the treatment of depression, and its potential for treatment of other psychiatric disorders is under study. Deep brain stimulation (DBS) involves delivering a current using implanted quadripolar electrodes connected to a battery-powered pulse-generating device. Sham-controlled trials represent the gold standard for establishing the efficacy of an intervention. An adequate placebo should be plausible and inactive, and it should simulate as closely as possible the ancillary effects of the treatment.

Keywords

affective appraisal systemanxiety disordersbrain systemsnegative emotionexecutive working memory systemclinical neuroimagingdepression
Type
Chapter
Information
Anxiety Disorders
Theory, Research and Clinical Perspectives
 , pp. 323 - 335
Publisher: Cambridge University Press
Print publication year: 2010

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