Joshua Brown

Title : Synaptic plasticity induced by transcranial magnetic stimulation

Abstract:

Transcranial Magnetic Stimulation (TMS) now has widespread clinical utility far outpacing an understanding of how it modulates the brain – limiting optimization. Behavioral and network effects are subserved by cellular changes, most prominently at the synapse. ‘Excitatory’ TMS is purported to work through a form of synaptic plasticity called long-term potentiation (LTP), a process which depends on NMDA receptors. TMS effects on the human motor system can be blocked by NMDA receptor antagonists and enhanced by NMDA receptor agonists – a pharmacologic augmentation approach successfully applied in a clinical trial for depression. In this presentation, I’ll highlight the preclinical and human physiology data pointing to mechanisms of action for the most commonly used clinical TMS protocols: 10-Hz repetitive TMS and intermittent theta burst stimulation.

Audience Take Away Notes:

• Understand how TMS can be used for brain disorders
• Understand the purported mechanisms of action, including long-term potentiation
• Appreciate how TMS could be optimized by leveraging purported mechanisms

Biography:

Joshua C. Brown, MD, PhD, is a psychiatrist, neurologist, and neuroscientist. He is an Assistant Professor of Psychiatry at Harvard Medical School, Medical Director of Transcranial Magnetic Stimulation (TMS), Director of the Brain Stimulation Mechanisms Laboratory, and Director of TMS research in the Division of Depression and Anxiety Disorders at McLean Hospital. Dr. Brown is internationally recognized for his work on the synaptic mechanisms of TMS, pharmacologic augmentation of TMS, and TMS parameter selection.