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Finger S, Sirgiovanni E. The electrified artist: Edvard Munch's demons, treatments, and sketch of an electrotherapy session (1908-1909). JOURNAL OF THE HISTORY OF THE NEUROSCIENCES 2024:1-34. [PMID: 38198672 DOI: 10.1080/0964704x.2023.2295201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
In 1908-1909, Norwegian artist Edvard Munch (1863-1944), best remembered for The Scream (1893), spent eight months under Daniel Jacobson's care in a private nerve clinic in Copenhagen. Munch was suffering from alcohol abuse, and his signs and symptoms included auditory hallucinations, persecutory delusions, paresthesias, paralyses, violent mood swings, depression, loss of control, fatigue, and the loss of his basic ability to take care of himself. He was treated with rest, a fortifying diet, massages, baths, fresh air, limited exercise, and nonconvulsive electrotherapy. After he had settled in, Jacobson allowed Munch to draw, paint, and engage in photography. Munch responded with a portrait of Jacobson and a small but intriguing sketch of himself at one of his electrotherapy sessions. In this article, we examine the circumstances that brought Munch to Jacobson's clinic and his therapies, with particular attention to electrotherapies. In so doing, we hope to provide a more complete picture of Munch's crisis in 1908, his nerve doctor, the rationales for medical electricity and other treatments he endured, and Scandinavian psychiatry at this moment in time.
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Affiliation(s)
- Stanley Finger
- Department of Psychological and Brain Sciences, Washington University, St. Louis, Missouri, USA
| | - Elisabetta Sirgiovanni
- Department of Molecular Medicine, Section of the History of Medicine, Sapienza University of Rome, Rome, Italy
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Mishra A, Pandey S. Functional Neurological Disorders: Clinical Spectrum, Diagnosis, and Treatment. Neurologist 2022; 27:276-289. [PMID: 35858632 DOI: 10.1097/nrl.0000000000000453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Functional neurological disorders (FNDs) are common but often misdiagnosed. REVIEW SUMMARY The incidence of FNDs is between 4 and 12 per 100,000, comparable to multiple sclerosis and amyotrophic lateral sclerosis, and it is the second most common diagnosis in neurology clinics. Some clues in the history are sudden onset, intermittent time course, variability of manifestation over time, childhood trauma, and history of other somatic symptoms. Anxiety and depression are common, but not necessarily more than in the general population. Although there are no tests currently capable of demonstrating whether symptoms are willfully produced, there may not be a clear categorical difference between voluntary and involuntary symptoms. The prognosis of an FND is linked to early diagnosis and symptom duration, but unfortunately, the majority of the patients are diagnosed after considerable delays. CONCLUSIONS A positive diagnosis of FNDs can be made on the basis of history and neurological signs without reliance on psychological stressors. Past sensitizing events and neurobiological abnormalities contribute to the pathogenesis of FNDs. Physical rehabilitation and psychological interventions alone or in combination are helpful in the treatment.
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Affiliation(s)
- Anumeha Mishra
- Department of Neurology, Govind Ballabh Pant Postgraduate institute of medical education and research; New Delhi, India
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Gonsalvez I, Spagnolo P, Dworetzky B, Baslet G. Neurostimulation for the treatment of functional neurological disorder: A systematic review. Epilepsy Behav Rep 2021; 16:100501. [PMID: 34950864 PMCID: PMC8671519 DOI: 10.1016/j.ebr.2021.100501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/28/2021] [Accepted: 11/04/2021] [Indexed: 01/02/2023] Open
Abstract
Functional Neurological Disorder (FND), also known as conversion disorder, is characterized by neurological symptoms that are incompatible with any known structural disorder and best explained by a biopsychosocial model. Evidence-based treatments for FND are limited, with cognitive behavioral therapy (CBT) and physiotherapy being the most effective interventions [1]. In recent years, functional neuroimaging studies have provided robust evidence of alterations in activity and connectivity in multiple brain networks in FND. This body of evidence suggests that neurocircuitry-based interventions, such as non-invasive brain stimulation techniques (NIBS), may also represent an effective therapeutic option for patients with FND. In this systematic review, we outline the current state of knowledge of NIBS in FND, and discuss limitations and future directions that may help establish the efficacy of NIBS as a therapeutic option for FND.
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Affiliation(s)
- Irene Gonsalvez
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Primavera Spagnolo
- Mary Horrigan Connors Center for Women's Health & Gender Biology, Department of Psychiatry, Brigham and Women Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Barbara Dworetzky
- Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Gaston Baslet
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
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Kucuker MU, Almorsy AG, Sonmez AI, Ligezka AN, Doruk Camsari D, Lewis CP, Croarkin PE. A Systematic Review of Neuromodulation Treatment Effects on Suicidality. Front Hum Neurosci 2021; 15:660926. [PMID: 34248523 PMCID: PMC8267816 DOI: 10.3389/fnhum.2021.660926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 05/17/2021] [Indexed: 12/15/2022] Open
Abstract
Introduction: Neuromodulation is an important group of therapeutic modalities for neuropsychiatric disorders. Prior studies have focused on efficacy and adverse events associated with neuromodulation. Less is known regarding the influence of neuromodulation treatments on suicidality. This systematic review sought to examine the effects of various neuromodulation techniques on suicidality. Methods: A systematic review of the literature from 1940 to 2020 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was conducted. Any reported suicide-related outcome, including suicidal ideation, suicide intent, suicide attempt, completed suicide in reports were considered as a putative measure of treatment effect on suicidality. Results: The review identified 129 relevant studies. An exploratory analysis of a randomized controlled trial comparing the effects of sertraline and transcranial direct-current stimulation (tDCS) for treating depression reported a decrease in suicidal ideation favoring tDCS vs. placebo and tDCS combined with sertraline vs. placebo. Several studies reported an association between repetitive transcranial magnetic stimulation and improvements in suicidal ideation. In 12 of the studies, suicidality was the primary outcome, ten of which showed a significant improvement in suicidal ideation. Electroconvulsive therapy (ECT) and magnetic seizure therapy was also shown to be associated with lower suicidal ideation and completed suicide rates. There were 11 studies which suicidality was the primary outcome and seven of these showed an improvement in suicidal ideation or suicide intent and fewer suicide attempts or completed suicides in patients treated with ECT. There was limited literature focused on the potential protective effect of vagal nerve stimulation with respect to suicidal ideation. Data were mixed regarding the potential effects of deep brain stimulation on suicidality. Conclusions: Future prospective studies of neuromodulation that focus on the primary outcome of suicidality are urgently needed. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=125599, identifier: CRD42019125599.
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Affiliation(s)
- Mehmet Utku Kucuker
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Ammar G. Almorsy
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Ayse Irem Sonmez
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Anna N. Ligezka
- Department of Clinical Genomics, Mayo Clinic, Rochester, MN, United States
| | - Deniz Doruk Camsari
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Charles P. Lewis
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Paul E. Croarkin
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
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Sirgiovanni E, Aruta A. The electroshock triangle: disputes about the ECT apparatus prototype and its display in the 1960s. HISTORY OF PSYCHIATRY 2020; 31:311-324. [PMID: 32308035 DOI: 10.1177/0957154x20916147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
In the early 1960s, a climate of public condemnation of electroconvulsive therapy was emerging in the USA and Europe. In spite of this, the electroshock apparatus prototype, introduced in Rome in 1938, was becoming hotly contended. This article explores the disputes around the display of the electroshock apparatus prototype in the summer of 1964 and sheds new light on the triangle of personalities that shaped its future: Karl and William Menninger, two key figures of American psychiatry in Topeka; their competitor, Adalberto Pazzini, the founder of the Sapienza Museum of the History of Medicine in Rome; and, between them, Lucio Bini, one of the original inventors of ECT, who died unexpectedly that summer.
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Lewis PM, Thomson RH, Rosenfeld JV, Fitzgerald PB. Brain Neuromodulation Techniques. Neuroscientist 2016; 22:406-21. [DOI: 10.1177/1073858416646707] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The modulation of brain function via the application of weak direct current was first observed directly in the early 19th century. In the past 3 decades, transcranial magnetic stimulation and deep brain stimulation have undergone clinical translation, offering alternatives to pharmacological treatment of neurological and neuropsychiatric disorders. Further development of novel neuromodulation techniques employing ultrasound, micro-scale magnetic fields and optogenetics is being propelled by a rapidly improving understanding of the clinical and experimental applications of artificially stimulating or depressing brain activity in human health and disease. With the current rapid growth in neuromodulation technologies and applications, it is timely to review the genesis of the field and the current state of the art in this area.
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Affiliation(s)
- Philip M. Lewis
- Department of Neurosurgery, Alfred Hospital, Melbourne, Victoria, Australia
- Department of Surgery, Central Clinical School, Monash University, Clayton, Victoria, Australia
- Monash Institute of Medical Engineering, Monash University, Clayton, Victoria, Australia
| | - Richard H. Thomson
- Monash Institute of Medical Engineering, Monash University, Clayton, Victoria, Australia
- Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Jeffrey V. Rosenfeld
- Department of Neurosurgery, Alfred Hospital, Melbourne, Victoria, Australia
- Department of Surgery, Central Clinical School, Monash University, Clayton, Victoria, Australia
- Monash Institute of Medical Engineering, Monash University, Clayton, Victoria, Australia
- F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Paul B. Fitzgerald
- Monash Institute of Medical Engineering, Monash University, Clayton, Victoria, Australia
- Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University, Melbourne, Victoria, Australia
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Krause B, Cohen Kadosh R. Can transcranial electrical stimulation improve learning difficulties in atypical brain development? A future possibility for cognitive training. Dev Cogn Neurosci 2013; 6:176-94. [PMID: 23770059 PMCID: PMC4064117 DOI: 10.1016/j.dcn.2013.04.001] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 04/07/2013] [Accepted: 04/08/2013] [Indexed: 12/19/2022] Open
Abstract
Transcranial electrical stimulation (TES) can improve cognitive training effects in adults. TES can enhance neuroplasticity from the molecular level to the system level. We discuss the usage of TES with cognitive training in atypically developing children. We discuss the possible cognitive and physical side effects of TES.
Learning difficulties in atypical brain development represent serious obstacles to an individual's future achievements and can have broad societal consequences. Cognitive training can improve learning impairments only to a certain degree. Recent evidence from normal and clinical adult populations suggests that transcranial electrical stimulation (TES), a portable, painless, inexpensive, and relatively safe neuroenhancement tool, applied in conjunction with cognitive training can enhance cognitive intervention outcomes. This includes, for instance, numerical processing, language skills and response inhibition deficits commonly associated with profound learning difficulties and attention-deficit hyperactivity disorder (ADHD). The current review introduces the functional principles, current applications and promising results, and potential pitfalls of TES. Unfortunately, research in child populations is limited at present. We suggest that TES has considerable promise as a tool for increasing neuroplasticity in atypically developing children and may be an effective adjunct to cognitive training in clinical settings if it proves safe. The efficacy and both short- and long-term effects of TES on the developing brain need to be critically assessed before it can be recommended for clinical settings.
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Affiliation(s)
- Beatrix Krause
- Department of Experimental Psychology, University of Oxford, Oxford, UK.
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Abstract
Since the 1980s and 1990s, vagus nerve and deep brain stimulation, transcranial magnetic stimulation and cranial electrotherapy stimulation have found their way into neurology as therapeutic approaches to epilepsy, Morbus Parkinson and other central nervous symptoms. Moreover, these methods have proven useful and provided hope in the therapy of other diseases, most of all in psychiatry. From a historic perspective, this new emphasis on somatic therapies in the case of transcranial magnetic stimulation and cranial electrotherapy stimulation represents the return of therapeutic methods widely used in the 19th century and based on very similar techniques. Against the background of a general rise in the importance of neurobiological concepts in the neurosciences, we are now in a new situation of change. Yet, as in the 1880s and 1990s, many epistemic questions remain unresolved, the methods not yet having been standardized. In particular, the inability to explain which way and precisely how electricity induces healing processes in the body continues to put the neurosciences, which have always regarded themselves as exact and scientific in nature, in a rather uncomfortable position. There was a similar situation in the 1880s and 1990s, when positivist scientific dogmas prevailed. For ideological and professional reasons, neurologists strongly rejected the notion pioneered by Leipzig neuropsychiatrist Paul Julius Möbius that curative effects of electrotherapy were based on suggestion. One should see, however, that Möbius's actual concern was not to raise opposition towards or question electrotherapy as such, but rather to sensitize his colleagues in view of the prevailing solely materialistic-somatic approach in order that they should not neglect the psychological component of all illness, both in clinical practice and in research. A singular and very special event illustrates the heated debate among German-speaking neurologists on the psychological/suggestive effects of electrotherapy in the last decade of the 19th century-namely the 'Frankfurt Council' of 1891. The statements made at the Frankfurt convention of 35 leading electrotherapists in opposition to Möbius's criticism very much resemble present-day arguments and attitudes. Yet neuroscientists of earlier generations also found very individual answers to fundamental questions in their field that might help both to understand problems from a long-term perspective and enrich present-day discussion as a beneficial corrective.
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Affiliation(s)
- Holger Steinberg
- Archives for the History of Psychiatry in Leipzig, Department of Psychiatry and Psychotherapy, Leipzig University, Semmelweisstr. 10, Leipzig D-04103, Germany.
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Araya Ibacache C, Leyton Robinson C. Atrapados sin salida: terapias de shock y la consolidación de la psiquiatría en Chile, 1930-1950. ACTA ACUST UNITED AC 2009. [DOI: 10.4000/nuevomundo.52793] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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