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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5250_Библиотеки_им_академика_М_И_Перельмана.pdf
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- •Foreword
- •Preface
- •Contents
- •1.1.2.5 Priming (Guiding) Transcranial Magnetic Stimulation (pTMS)
- •1.1.2.6 Synchronized Transcranial Magnetic Stimulation (sTMS)
- •1.1.2.8 Magnetic Seizure Therapy (MST)
- •1.2.1 Treatment Procedures
- •1.2.2 TMS Treatment Precautions
- •1.2.2.1 Seizure Risk
- •1.2.2.3 Other Precautions
- •1.3.1.1 Membrane Potential Alterations
- •1.4 Effect Factors
- •1.4.1 Stimulation Frequency
- •About the Editors
- •1: Transcranial Magnetic Stimulation
- •1.1 Introduction
- •1.1.2.1 Repetitive Transcranial Magnetic Stimulation (rTMS)
- •1.1.2.2 Prolonged Intermittent Theta Burst Stimulation (piTBS)
- •1.1.2.4 Deep Transcranial Magnetic Stimulation (dTMS)
- •1.4.2 Stimulation Intensity
- •1.4.3 Pulse Duration
- •1.4.5 Interstimulus Interval
- •1.5 Conclusion
- •References
- •2: Transcranial Direct Current Stimulation
- •2.1 Introduction
- •2.3.3 Nonneuronal Mechanisms
- •2.3.4 Others
- •2.4 Effect Factors
- •2.4.1 Stimulus Polarity
- •2.4.2 Duration
- •2.4.3 Current Intensity
- •2.4.4 Others
- •2.5 Summary and Outlook
- •References
- •3: Major Depressive Disorder
- •3.1 Introduction
- •3.2 TMS
- •3.2.1 rTMS
- •3.2.1.1 Unilateral rTMS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •3.2.1.2 Bilateral rTMS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •3.2.1.3 Accelerated rTMS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •3.2.2 Deep TMS
- •3.2.2.1 Efficacy
- •3.2.2.2 Safety
- •3.2.2.3 Treatment Regimen
- •3.2.2.4 Clinical Recommendations
- •3.2.3 Priming rTMS
- •3.2.3.1 Efficacy
- •3.2.3.2 Safety
- •3.2.3.3 Treatment Regimen
- •3.2.3.4 Clinical Recommendations
- •3.2.4 Synchronized rTMS
- •3.2.4.1 Efficacy
- •3.2.4.2 Safety
- •3.2.4.3 Treatment Regimen
- •3.2.4.4 Clinical Recommendations
- •3.2.5 TBS
- •3.2.5.1 iTBS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •3.2.5.2 Accelerated iTBS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •3.2.5.3 Continuous TBS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •3.2.5.4 Bilateral TBS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •3.2.6 Magnetic Seizure Therapy (MST)
- •3.2.6.1 Efficacy
- •3.2.6.2 Safety
- •3.2.6.3 Treatment Regimen
- •3.2.6.4 Clinical Recommendations
- •3.3 tDCS
- •3.3.1 Conventional tDCS
- •3.3.1.1 Efficacy
- •3.3.1.3 Treatment Regimen
- •3.3.1.4 Clinical Recommendations
- •3.3.2 HD-tDCS
- •3.3.2.1 Efficacy
- •3.3.2.2 Safety
- •3.3.2.3 Treatment Regimen
- •3.3.2.4 Clinical Recommendations
- •3.4 TMS Vs. tDCS
- •3.4.1 Efficacy
- •3.4.2 Safety
- •3.5 Conclusion
- •References
- •3.3.1.2 Safety
- •4: Bipolar Disorder
- •4.1 Introduction
- •4.2 TMS
- •4.2.1 rTMS
- •4.2.1.1 Unilateral rTMS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •4.2.1.2 Bilateral rTMS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •4.2.1.3 Accelerated rTMS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •4.2.2 Deep TMS
- •4.2.2.1 Efficacy
- •4.2.2.2 Safety
- •4.2.2.3 Treatment Regimen
- •4.2.2.4 Clinical Recommendations
- •4.2.3 Priming TMS
- •4.2.3.1 Efficacy
- •4.2.3.2 Safety
- •4.2.3.3 Treatment Regimen
- •4.2.3.4 Clinical Recommendations
- •4.2.4 Synchronized TMS
- •4.2.4.1 Efficacy
- •4.2.4.2 Safety
- •4.2.4.3 Treatment Regimen
- •4.2.4.4 Clinical Recommendations
- •4.2.5 TBS
- •4.2.5.1 iTBS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •4.2.5.2 Accelerated iTBS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •4.2.5.3 Continuous TBS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •4.2.5.4 Bilateral TBS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •4.2.6 MST
- •4.2.6.1 Efficacy
- •4.2.6.2 Safety
- •4.2.6.3 Treatment Regimen
- •4.2.6.4 Clinical Recommendations
- •4.3 tDCS
- •4.3.1 Conventional tDCS
- •4.3.1.1 Efficacy
- •4.3.1.2 Safety
- •4.3.1.3 Treatment Regimen
- •4.3.1.4 Clinical Recommendations
- •4.3.2 HD-tDCS
- •4.3.2.1 Efficacy
- •4.3.2.2 Safety
- •4.3.2.3 Treatment Regimen
- •4.3.2.4 Clinical Recommendations
- •4.4 TMS vs. tDCS
- •4.4.1 Efficacy
- •4.4.2 Safety
- •4.5 Conclusion
- •References
- •5: Schizophrenia
- •5.1 Schizophrenia
- •5.2 TMS
- •5.2.1 rTMS
- •5.2.1.1 Unilateral rTMS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •5.2.1.2 Bilateral rTMS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •5.2.1.3 Accelerated rTMS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •5.2.2 Deep TMS
- •5.2.2.1 Efficacy
- •5.2.2.2 Safety
- •5.2.2.3 Treatment Regimen
- •5.2.2.4 Clinical Recommendations
- •5.2.3 Priming TMS
- •5.2.3.1 Efficacy
- •5.2.3.2 Safety
- •5.2.3.3 Treatment Regimen
- •5.2.3.4 Clinical Recommendations
- •5.2.4 Synchronized TMS
- •5.2.4.1 Efficacy
- •5.2.4.2 Safety
- •5.2.4.3 Treatment Regimen
- •5.2.4.4 Clinical Recommendations
- •5.2.5 TBS
- •5.2.5.1 iTBS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •5.2.5.2 Accelerated iTBS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •5.2.5.3 Continuation TBS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •5.2.5.4 Bilateral TBS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •5.2.6 MST
- •5.2.6.1 Efficacy
- •5.2.6.2 Safety
- •5.2.6.3 Treatment Regimen
- •5.2.6.4 Clinical Recommendations
- •5.3 tDCS
- •5.3.1 Conventional tDCS
- •5.3.1.1 Efficacy
- •5.3.1.2 Safety
- •5.3.1.3 Treatment Regimen
- •5.3.1.4 Clinical Recommendations
- •5.3.2 HD-tDCS
- •5.3.2.1 Efficacy
- •5.3.2.2 Safety
- •5.3.2.3 Treatment Regimen
- •5.3.2.4 Clinical Recommendations
- •5.4 TMS vs. tDCS
- •5.4.1 Efficacy
- •5.4.2 Safety
- •5.5 Conclusion
- •References
- •6: Addictive Disorders
- •6.1 Addictive Disorders
- •6.2 TMS
- •6.2.1 rTMS
- •6.2.1.1 Unilateral rTMS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •6.2.1.2 Bilateral rTMS
- •6.2.1.3 Accelerated rTMS
- •6.2.2 Deep TMS
- •6.2.3 Priming TMS
- •6.2.4 Synchronized TMS
- •6.2.5 TBS
- •6.2.5.1 iTBS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •6.2.5.2 Accelerated iTBS
- •6.2.5.3 Continuous TBS
- •6.2.5.4 Bilateral TBS
- •6.2.6 MST
- •6.3 tDCS
- •6.3.1 Conventional tDCS
- •6.3.1.1 Efficacy
- •6.3.1.2 Safety
- •6.3.1.3 Treatment Regimen
- •6.3.1.4 Clinical Recommendations
- •6.3.2 HD-tDCS
- •6.4 TMS vs. tDCS
- •6.4.1 Efficacy
- •6.4.2 Safety
- •6.5 Conclusion
- •References
- •7: Obsessive-Compulsive Disorder
- •7.1 Introduction
- •7.2 TMS
- •7.2.1 rTMS
- •7.2.1.1 Unilateral rTMS
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •7.2.1.2 Bilateral rTMS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •7.2.1.3 Accelerated rTMS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •7.2.2 Deep TMS
- •7.2.2.1 Efficacy
- •7.2.2.2 Safety
- •7.2.2.3 Treatment Regimen
- •7.2.2.4 Clinical Recommendations
- •7.2.3 Priming TMS
- •7.2.3.1 Efficacy
- •7.2.3.2 Safety
- •7.2.3.3 Treatment Regimen
- •7.2.3.4 Clinical Recommendations
- •7.2.4 Synchronized TMS
- •7.2.4.1 Efficacy
- •7.2.4.2 Safety
- •7.2.4.3 Treatment Regimen
- •7.2.4.4 Clinical Recommendations
- •7.2.5 TBS
- •7.2.5.1 iTBS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •7.2.5.2 Accelerated iTBS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •7.2.5.3 Continuation TBS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •7.2.5.4 Bilateral TBS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •7.2.6 MST
- •7.2.6.1 Safety
- •7.2.6.2 Treatment Regimen
- •7.2.6.3 Clinical Recommendations
- •7.3 tDCS
- •7.3.1 Conventional tDCS
- •7.3.1.1 Efficacy
- •7.3.1.2 Safety
- •7.3.1.3 Treatment Regimen
- •7.3.1.4 Clinical Recommendations
- •7.3.2 HD-tDCS
- •7.3.2.1 Efficacy
- •7.3.2.2 Safety
- •7.3.2.3 Treatment Regimen
- •7.3.2.4 Clinical Recommendations
- •7.4 TMS vs. tDCS
- •7.4.1 Efficacy
- •7.4.2 Safety
- •7.5 Conclusion
- •References
- •8: Attention Deficit Hyperactivity Disorder
- •8.1 ADHD
- •8.1.2 Therapeutic Method
- •8.2 TMS
- •8.2.1 Single-Pulse TMS (spTMS)
- •8.2.1.1 Efficacy
- •8.2.1.2 Safety
- •8.2.1.3 Treatment Regimen
- •8.2.1.4 Clinical Recommendations
- •8.2.2 Paired-Pulse TMS (ppTMS)
- •8.2.2.1 Efficacy
- •8.2.2.2 Safety
- •8.2.2.3 Treatment Regimen
- •8.2.2.4 Clinical Recommendations
- •8.2.3 rTMS
- •8.2.3.1 Low-Frequency rTMS (LF-rTMS)
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •8.2.3.2 High-Frequency rTMS (HF-rTMS)
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •8.2.4 TBS
- •8.2.4.1 Intermittent TBS (iTBS)
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •8.2.4.2 Continuous iTBS (cTBS)
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •8.3 tDCS
- •8.3.1 Conventional tDCS
- •8.3.1.1 Efficacy
- •8.3.1.2 Safety
- •8.3.1.3 Treatment Regimen
- •8.3.1.4 Clinical Recommendations
- •8.3.2.1 Efficacy
- •8.3.2.2 Safety
- •8.3.2.3 Treatment Regimen
- •8.3.2.4 Clinical Recommendations
- •8.4 TMS vs. tDCS
- •8.4.1 Efficacy
- •8.4.2 Safety
- •8.5 Conclusion
- •References
- •9: Autism Spectrum Disorder
- •9.1 Introduction
- •9.2 rTMS
- •9.2.1 Unilateral rTMS
- •9.2.1.1 Efficacy
- •9.2.1.2 Safety
- •9.2.1.3 Treatment Regimen
- •9.2.1.4 Clinical Recommendations
- •9.2.1.5 Bilateral rTMS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •9.2.1.6 Accelerated rTMS
- •9.2.2 Deep TMS
- •9.2.2.1 Efficacy
- •9.2.2.2 Safety
- •9.2.2.3 Treatment Regimen
- •9.2.2.4 Clinical Recommendations
- •9.2.3 Priming TMS
- •9.2.4 Synchronized TMS
- •9.2.5 TBS
- •9.2.5.1 iTBS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •9.2.5.2 Accelerated iTBS
- •9.2.5.3 Continuation TBS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •9.2.5.4 Bilateral TBS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •9.2.6 MST
- •9.3 tDCS
- •9.3.1 Conventional tDCS
- •9.3.1.1 Efficacy
- •9.3.1.2 Safety
- •9.3.1.3 Treatment Regimen
- •9.3.1.4 Clinical Recommendations
- •9.3.2 HD-tDCS
- •9.3.2.1 Efficacy
- •9.3.2.2 Safety
- •9.3.2.3 Treatment Regimen
- •9.3.2.4 Clinical Recommendations
- •9.4 TMS Vs. tDCS
- •9.4.1 Efficacy
- •9.4.1.1 Cognitive Effects
- •9.4.1.3 Biological Effects
- •9.4.2 Safety
- •9.5 Conclusion
- •References
- •10: Anxiety Disorder
- •10.1 Introduction
- •10.2 TMS
- •10.2.1 rTMS
- •10.2.1.1 Unilateral rTMS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •10.2.1.2 Bilateral rTMS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •10.2.1.3 Accelerated rTMS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •10.2.2 Deep TMS
- •10.2.2.1 Efficacy
- •10.2.2.2 Safety
- •10.2.2.3 Treatment Regimen
- •10.2.2.4 Clinical Recommendations
- •10.2.3 Priming TMS
- •10.2.3.1 Efficacy
- •10.2.3.2 Safety
- •10.2.3.3 Treatment Regimen
- •10.2.3.4 Clinical Recommendations
- •10.2.4 Synchronized TMS
- •10.2.4.1 Efficacy
- •10.2.4.2 Safety
- •10.2.4.3 Treatment Regimen
- •10.2.4.4 Clinical Recommendations
- •10.2.5 TBS
- •10.2.5.1 iTBS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •10.2.5.2 Accelerated iTBS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •10.2.5.3 Continuation TBS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •10.2.5.4 Bilateral TBS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •10.2.6 Magnetic Seizure Therapy (MST)
- •10.3 tDCS
- •10.3.1 Conventional tDCS
- •10.3.1.1 Efficacy
- •10.3.1.2 Safety
- •10.3.1.3 Treatment Regimen
- •10.3.1.4 Clinical Recommendations
- •10.3.2 HD-tDCS
- •10.3.2.1 Efficacy
- •10.3.2.2 Safety
- •10.3.2.3 Clinical Recommendations
- •10.4 TMS versus tDCS
- •10.4.1 Efficacy
- •10.4.2 Safety
- •10.5 Conclusion
- •References
- •11: Post-traumatic Stress Disorder
- •11.1 Introduction
- •11.2 TMS
- •11.2.1 rTMS
- •11.2.1.1 Unilateral rTMS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •11.2.1.2 Bilateral rTMS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •11.2.1.3 Accelerated rTMS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •11.2.2 Deep TMS
- •11.2.2.1 Efficacy
- •11.2.2.2 Safety
- •11.2.2.3 Treatment Regimen
- •11.2.2.4 Clinical Recommendations
- •11.2.3 Priming TMS
- •11.2.3.1 Efficacy
- •11.2.3.2 Safety
- •11.2.3.3 Treatment Regimen
- •11.2.3.4 Clinical Recommendations
- •11.2.4 Synchronized TMS
- •11.2.4.1 Efficacy
- •11.2.4.2 Safety
- •11.2.4.3 Treatment Regimen
- •11.2.4.4 Clinical Recommendations
- •11.2.5 TBS
- •11.2.5.1 iTBS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •11.2.5.2 Accelerated iTBS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •11.2.5.3 Bilateral TBS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •11.2.6 MST
- •11.2.6.1 Efficacy
- •11.2.6.2 Safety
- •11.2.6.3 Treatment Regimen
- •11.2.6.4 Clinical Recommendations
- •11.3 tDCS
- •11.3.1 Conventional tDCS
- •11.3.1.1 Efficacy
- •11.3.1.2 Safety
- •11.3.1.3 Treatment Regimen
- •11.3.1.4 Clinical Recommendations
- •11.3.2 HD-tDCS
- •11.3.2.1 Efficacy
- •11.3.2.2 Safety
- •11.3.2.3 Treatment Regimen
- •11.3.2.4 Clinical Recommendations
- •11.4 TMS vs. tDCS
- •11.4.1 Efficacy
- •11.4.2 Safety
- •11.5 ECT
- •11.5.1 Efficacy
- •11.5.2 Safety
- •11.5.3 Treatment Regimen
- •11.5.4 Clinical Recommendations
- •11.6 Conclusion
- •References
- •12: Sleep Disorders
- •12.1 Introduction
- •12.2 TMS
- •12.2.1 rTMS
- •12.2.1.1 Unilateral rTMS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •12.2.1.2 Bilateral rTMS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •12.2.1.3 Accelerated rTMS
- •12.2.2 Deep TMS
- •12.2.3 Priming TMS
- •12.2.4 Synchronised TMS
- •12.2.5 TBS
- •12.2.5.1 iTBS
- •12.2.5.2 Accelerated iTBS
- •12.2.5.3 cTBS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •12.2.5.4 Bilateral TBS
- •12.2.6 MST
- •12.3 tDCS
- •12.3.1 Efficacy
- •12.3.2 Safety
- •12.3.3 Treatment Regimen
- •12.3.4 Clinical Recommendations
- •12.4 TMS Combined tDCS
- •12.4.1 Efficacy
- •12.4.2 Safety
- •12.5 Conclusion
- •References
- •13: Neurocognitive Disorders
- •13.1 Introduction
- •13.2 TMS
- •13.2.1 TMS
- •13.2.1.1 Conventional rTMS
- •Efficacy
- •Safety
- •Treatment Regimen
- •Clinical Recommendations
- •13.2.1.2 Accelerated rTMS
- •13.2.2 Deep TMS
- •13.2.2.1 Efficacy
- •13.2.2.2 Safety
- •13.2.2.3 Treatment Regimen
- •13.2.2.4 Clinical Recommendations
- •13.2.3 Priming TMS
- •13.2.4 Synchronized TMS
- •13.2.5 iTBS
- •13.2.5.1 Efficacy
- •13.2.5.2 Safety
- •13.2.5.3 Treatment Regimen
- •13.2.5.4 Clinical Recommendations
- •13.2.6 Magnetic Seizure Therapy
- •13.3.1 Conventional tDCS
- •13.3.1.1 Efficacy
- •13.3.1.2 Safety
- •13.3.1.3 Treatment Regimen
- •13.3.1.4 Clinical Recommendations
- •13.3.2 HD-tDCS
- •13.3.2.1 Efficacy
- •13.3.2.2 Safety
- •13.3.2.3 Treatment Regimen
- •13.3.2.4 Clinical Recommendations
- •13.4 TMS vs. tDCS
- •13.4.1 Efficacy
- •13.4.2 Safety
- •13.5 Conclusion
- •References

1 Transcranial Magnetic Stimulation
(>1 Hz) depolarizes neurons, enhancing excitability and synaptic connections,
resembling long-term potentiation (LTP).
9
1.4.2 Stimulation Intensity
1.4.2.1 Definition andQuantification Method
Stimulation intensity is a parameter measuring the degree of impact of the magnetic
eld generated by TMS on brain neural tissues. In practical applications, it is usually expressed as a percentage of the maximum output power of the transcranial
magnetic stimulator. This quantication method facilitates comparison and standardization of stimulation intensity under different equipment and experimental/
treatment conditions.
1.4.2.2 Impact onNeural Tissues andSafety Considerations
Stimulation intensity directly correlates with neuronal activation [31, 32]. Higher
intensity increases the magnetic eld strength, inducing a larger current in brain tissues, which may trigger neuronal action potentials. However, excessive intensity
can lead to discomfort, including scalp pain and headaches, and may elevate the risk
of seizures. Therefore, careful titration is essential to determine the optimal intensity for effective neuronal stimulation while minimizing adverse effects. For motor
cortex stimulation, the intensity is typically adjusted to achieve a stable minimum
motor evoked potential (MEP), serving as a reference for safe and effective
stimulation.
1.4.3 Pulse Duration
1.4.3.1 Definition andPhysical Significance
Pulse duration refers to the length of time a single magnetic stimulation pulse lasts,
which is the temporal dimension parameter of the TMS pulse. From a physical perspective, it determines the time span during which the magnetic eld acts on brain
neural tissues.
1.4.3.2 Impact onStimulation Effects
Pulse duration signicantly affects the spatial characteristics of TMS stimulation
[33]. A shorter pulse duration tends to produce a more focal stimulation effect
because the shorter action time concentrates the magnetic eld energy in a smaller
area, allowing for more precise stimulation of specic target regions in the cerebral
cortex. Conversely, a longer pulse duration distributes the magnetic eld energy
more widely over time, which may expand the stimulation range but could reduce
the spatial precision. In neuroscience research, especially when precisely locating
and studying brain functional areas, careful control of pulse duration is essential to
accurately explore the functions of specic brain regions and minimize unnecessary
interference with surrounding nontarget areas.

10
Y. Liu and S. Hu
1.4.4 Number ofPulses andStimulation Time
1.4.4.1 Definition andInterrelationship
The number of pulses refers to the total number of magnetic stimulation pulses
applied during a single TMS treatment session or experimental operation.
Stimulation time refers to the duration from the start to the end of the entire TMS
stimulation process. There is a close relationship between them, and the stimulation
time can be calculated by the number of pulses and the pulse frequency (Stimulation
time=Number of pulses/Pulse frequency).
1.4.4.2 Impact onNeuromodulation Effects
The number of pulses and stimulation time jointly determine the cumulative effect
of TMS on brain neuron activities. A larger number of pulses and a longer stimulation time usually subject neurons to more continuous stimulation, resulting in more
persistent neuromodulation effects. For example, accelerated TBS protocols present
an opportunity to deliver higher pulse doses in shorter periods of time, thus resulting
in faster and potentially more clinically effective treatment [34].
1.4.5 Interstimulus Interval
1.4.5.1 Definition andMechanism ofAction
The interstimulus interval refers to the time interval between two adjacent magnetic
stimulation pulses during the process of repeatedly applying magnetic stimulation.
It is another important parameter for regulating the rhythm of TMS stimulation and
plays a crucial role in simulating the natural neural activity rhythm of the brain and
regulating neuronal plasticity.
1.4.5.2 Application inNeuroplasticity Regulation
An appropriate interstimulus interval can simulate the rhythm of the brain’s
natural neural activity, promoting synchronized activities between neurons [35,
36]. For example, in the theta burst stimulation (TBS) mode, the interstimulus
interval is set according to the rhythm of the theta wave (4–7Hz). This interstimulus interval that matches the brain’s natural rhythm can effectively regulate the brain’s plasticity, enhancing or inhibiting synaptic plasticity through
mechanisms such as affecting postsynaptic potentials, neurotransmitter release,
and intracellular signal transduction. In research and treatment related to diseases associated with neuroplasticity (such as memory disorders, neurorehabilitation, etc.), reasonably setting the interstimulus interval is an important strategy
for optimizing TMS treatment effects.

1 Transcranial Magnetic Stimulation
11
1.5 Conclusion
TMS is a noninvasive neuromodulation method. It functions via electromagnetic
induction, affecting neuronal activity in the cerebral cortex. There are various
advanced TMS approaches such as rTMS, piTBS, and so on, each with distinct
applications. Treatment involves pretreatment steps, actual stimulation with monitoring, and posttreatment evaluation. Precautions are needed regarding seizures,
auditory/vestibular issues, discomfort, and for specic patient groups. TMS impacts
membrane potential, synaptic plasticity, and neural circuits through mechanisms
related to ion channels and different stimulation parameters. Future TMS research
should clarify its mechanisms better. Clinical applications may expand with personalized protocols and integration with other treatments. Technological improvements
in coil design and monitoring could enhance precision. Wider patient access and
better acceptance are crucial for its full potential to be realized, promising greater
impact on treating neuropsychiatric disorders in the future.
Conict of Interest The authors declare no competing interests.
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Y. Liu and S. Hu

Transcranial Direct Current Stimulation
JiaxinFu, LihaoZheng, HongwenSong,
andXiaochuZhang
Abstract
Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation
technique that exhibits promising therapeutic potential in the treatment of chronic
pain, neurological disorders, and psychiatric disorders. Despite its widespread
application, there remains a lack of standardized guidelines regarding the impact
of various tDCS parameters (such as polarity, electrode size and placement, stimulation duration) on the induction of neurophysiological and behavioral effects.
In this chapter, we present a comprehensive overview of the current understanding of tDCS encompassing its fundamental principles and common parameters,
treatment protocols and precautionary measures, potential mechanisms underlying its effects, as well as inuential factors. Future studies are warranted to further elucidate its mechanism of action and explore more efcacious stimulus
programs.
2
Keywords
Neuromodulation · Noninvasive brain stimulation · Transcranial direct current
stimulation (tDCS) · High-denition tDCS (HD-tDCS) · Personalized tDCS ·
Home-based tDCS
J. Fu · L. Zheng · H. Song (*) · X. Zhang (*)
Division of Life Science and Medicine, Department of Radiology, The First Afliated
Hospital of USTC, School of Life Science, University of Science & Technology of China,
Hefei, China
e-mail: shw0519@ustc.edu.cn; zxcustc@ustc.edu.cn
© The Author(s), under exclusive license to Springer Nature Singapore Pte
Ltd. 2025
W. Zheng, Y. Ning (eds.), TMS and tDCS for Psychiatric Disorders,
https://doi.org/10.1007/978-981-96-8504-2_2
15

16
J. Fu et al.
Abbreviations
1
H MRS proton magnetic resonance spectroscopy
A electric current
AEs adverse events
AMPA α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid
ASL arterial spin labeling
C stimulation charge
C3, Fp2, F3, F4 the standard electroencephalography (EEG) electrode position
CBF cerebral blood ow
CBZ channel blocker carbamazepine
DA dopamine
DC direct current
DLPFC dorsolateral prefrontal cortex
DMN the default mode network
DMO dextromethorphan
E excitatory neurotransmitters
EEG electroencephalogram
FLU channel blocker unarizine
fMRI functional magnetic resonance imaging
FPNs frontoparietal networks
GABA gamma-aminobutyric acid
GABAA gamma-aminobutyric acid type A
HD-tDCS high-denition transcranial direct current stimulation
I inhibitory neurotransmitters
J stimulation energy, with the unit being joules
LOR Lorazepam
LTD long-term depression
LTP long-term potentiation
MEP motor evoked potential
MHC I major histocompatibility complex I
MR magnetic resonance
MRI magnetic resonance imaging
M1 the primary motor cortex
M1-SO an electrode site connected to the sensorimotor cortex
NA noradrenaline
NMDA N-methyl-D-aspartate
PET positron emission computed tomography
rCBF regional cerebral blood ow
RSN resting-state network
rTMS repetitive transcranial magnetic stimulation
SHAM sham stimulation
t time
tDCS transcranial direct current stimulation
tNAA N-acetylaspartate

2 Transcranial Direct Current Stimulation
17
TMS transcranial magnetic stimulation
V voltage
VMR vasomotor reactivity
W stimulation power, the unit is watts
2.1 Introduction
2.1.1 Fundamentals oftDCS
Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation
technique, in which electrodes placed on the scalp deliver a weak direct current
(typically 1–2 mA) to modulate neuronal excitability in specic targeted brain
regions [1–3]. The systematic investigation of tDCS can be traced back to the 1960s;
however, most research groups at that time employed current intensities and stimulation durations that were insufcient to induce profound changes in cerebral excitability. It was not until 2000 when tDCS was denitively demonstrated to polarize
the cerebral cortex through the application of weak constant currents, thereby modulating neuronal excitability. This discovery led to a resurgence of research interest
in tDCS [1]. Concurrently, advancements in signal processing and imaging technologies, such as functional magnetic resonance imaging (fMRI), positron emission
computed tomography (PET), and electroencephalogram (EEG), have facilitated
the integration of tDCS with these techniques, propelling tDCS into the domain of
robust brain function analysis and neurophysiology research, thus reestablishing it
as a prominent subject of investigation [4, 5].
The tDCS device utilized is a battery-powered current generator capable of
delivering a constant electrical current ow of up to 2mA.Typically, the device
employs two large sponge-electrodes soaked in saline solution or a ring array for
targeted delivery of the current [4, 6]. The two sponges, soaked in saline solution,
typically have an area ranging from 20 to 35cm2 and are equipped with slits for the
placement of electrodes (an anode and cathode), thus forming an electrode-sponge
unit [7, 8]. The purpose of electrodes in tDCS is to facilitate the efcient transmission of current from the stimulation device to the scalp [5]. Standard tDCS electrodes (pads) are typically square 5× 5cm or 5× 7cm [9], 9cm2, and smaller
electrodes (pads) are also used. Standard tDCS electrode assemblies employ either
metallic or conductive rubber electrodes, which serve as the site of electrochemical
reactions and should not come into direct contact with the skin [5, 10]. Electrolytes
are commonly isotonic saline, saturated in a sponge that envelops the electrode,
serving as a buffer between the electrode and the skin. Sufcient electrolyte volume
is essential to prevent chemicals generated at the electrode from reaching the skin;
however, conductive gels and/or creams have also been employed [5, 10]. Due to
their size and material composition, the number of pad electrodes is typically
restricted to a maximum of 3–4 [10]. The shape and size of the sponges are intentionally designed to facilitate a homogeneous distribution of current across the
stimulation area, thereby mitigating the risk of skin burns resulting from localized

18
J. Fu et al.
electric concentrations (referred to as “hot spots”) at the interface between the
sponge and skin [5, 7].
tDCS involves the application of either anodal or cathodal stimulation, which
typically elicit contrasting effects [4]. The positioning of the anode and cathode
electrodes determines the direction of electrical current ow across the brain [6].
The electrode through which the current is directed into the brain is commonly
referred to as the anode, while the electrode through which the current exits the
body is known as the cathode [11]. Precise placement of these electrodes plays a
crucial role in tDCS application, and any deviations from predetermined scalp locations may signicantly impact its outcomes [6]. Typically, electrode positioning on
the scalp follows guidelines derived from the International EEG 10–20 System [5,
7]. One electrode-sponge unit is positioned on the scalp, while the second can be
placed at a different cephalic location (referred to as bipolar or bicephalic montage)
or an extracephalic location (known as unipolar or monocephalic montage), typically on the shoulder or upper arm [7]. The most commonly utilized electrode montages in tDCS research include the left anodal M1-SO (C3-right supraorbital region
[Fp2]) montage and the bilateral frontal (F3-F4) montage [6]. Once desired locations are identied, elastic straps are utilized to securely fasten the electrode assembly onto the scalp for precise current delivery. Inadequate or excessive tightening of
these straps may result in electrode displacement during the course of a tDCS session. Moreover, excessive tightening of electrode straps can lead to an elevated likelihood of saline leakage from the electrode sponges [5].
Conventional tDCS, utilizing large electrode congurations, leads to the activation of relatively extensive cortical regions. A fraction of the electrical current is
diverted by the scalp, while the remaining portion effectively reaches the brain tissue and elicits diffuse alterations in cortical excitability. To address the limited spatial resolution of conventional tDCS, several methods have been proposed to
enhance stimulation focus. In 2009, a novel electrode conguration known as highdenition tDCS (HD-tDCS) was developed with the aim of improving stimulation
focality and enabling precise targeting of specic brain regions [12]. In contrast to
conventional tDCS, which typically employs two larger electrodes, HD-tDCS utilizes multiple smaller electrodes (approximately 1cm2) for enhanced spatial targeting. Moreover, the position and current intensity at each electrode can be optimized
to improve precision or targeting [5, 7, 13]. Smaller electrodes offer the advantage
of accommodating a larger number of electrodes and/or positioning them in closer
proximity [14]. A commonly employed electrode conguration for HD tDCS is a
4×1 ring, consisting of a central electrode surrounded by four polarity-opposite
peripheral electrodes [13]. In comparison to conventional tDCS, the 4×1 ringshaped HD-tDCS elicits a more localized brain stimulation, conning the induced
modulation of cortical excitability within the boundaries of the ring electrode. The
concentration of the electric eld’s peak within the central electrode area enhances
stimulation precision and current intensity, ensuring a high current density in the
target region while minimizing undesired effects on nontarget brain areas [13, 15].
In addition to enhanced focality, the effects of HD-tDCS on cortical excitability
persist for a minimum duration of 30 min longer than those observed with
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