Publications by authors named "Emily M Beydler"
Introduction: Bipolar major depressive episodes with mixed features are diagnosed in patients who meet the full criteria for a major depressive episode exhibiting three additional concurrent symptoms of hypomania or mania. Up to half of patients with bipolar disorder experience mixed episodes, which are more likely to be treatment-refractory than pure depression or mania/hypomania alone.
Case: We present a 68-year-old female with Bipolar Type II Disorder with a four-month medication-refractory major depressive episode with mixed features referred for neuromodulation consultation.
Introduction: Status epilepticus (SE) has a mortality rate of 20 to 50%, with acute symptomatic SE having a higher risk compared to chronic SE. Electroconvulsive therapy (ECT) has been utilized for the treatment of refractory SE with a success rate estimate of 57.9%.
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- Transcranial magnetic stimulation (TMS) is a noninvasive technique used in psychiatry to treat conditions like depression and anxiety, but existing methods often overlook individual anatomical differences.
- A new protocol combines functional MRI and electric-field modeling to tailor TMS targeting for individual patients, emphasizing the importance of accurately defining stimulation sites and coil orientations.
- This method shows advantages over standard approaches by decreasing variability and optimizing the distance and orientation for effective stimulation, though it requires some expertise in MRI processing and takes about 24 hours to implement.
Article Synopsis
- Anxiety disorders are common but lack effective drug treatments, highlighting the need for new therapies like noninvasive neuromodulation.
- The study tested whether inhibitory rTMS on the intraparietal sulcus could reduce anxiety during shock threat scenarios by measuring both physiological responses and subjective anxiety levels.
- Results showed that active rTMS lowered physiological arousal linked to fear and anxiety, supporting the idea that targeting the IPS could be a promising treatment avenue for anxiety disorders.
Much of the mechanistic research on anxiety focuses on subcortical structures such as the amygdala; however, less is known about the distributed cortical circuit that also contributes to anxiety expression. One way to learn about this circuit is to probe candidate regions using transcranial magnetic stimulation (TMS). In this study, we tested the involvement of the dorsolateral prefrontal cortex (dlPFC), in anxiety expression using 10 Hz repetitive TMS (rTMS).
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