PDF(Pubmed)
Abstract：
A variety of neuromodulation treatments are available today and more are on the way, but are tomorrow\'s psychiatrists prepared to incorporate these tools into their patients\' care plans? This article addresses the need for training in clinical neuromodulation for general psychiatry trainees. To ensure patient access to neuromodulation treatments, we believe that general psychiatrists should receive adequate education in a spectrum of neuromodulation modalities to identify potential candidates and integrate neuromodulation into their multidisciplinary care plans. We propose curricular development across the four FDA-cleared modalities currently available in psychiatric practice: electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), deep brain stimulation (DBS), and vagus nerve stimulation (VNS). With a focus on psychiatry residency training, the article delineates core learning components for each neuromodulation technique. For each modality, we review the clinical training status, the respective FDA-cleared indications, mechanisms of action, clinical indications and contraindications, adverse effects, informed consent process, dosing considerations, and clinical management guidelines. The approach outlined in this article aims to contribute to the development of a well-rounded generation of psychiatry trainees with the capacity to navigate the growing field of neuromodulation. Whether or not a psychiatrist specializes in delivering neuromodulation therapies themselves, it is incumbent on all psychiatrists to be able to identify patients who should be referred to neuromodulation therapies, and to provide comprehensive patient care before, during and after clinical neuromodulation interventions to optimize outcomes and prevent relapse.
摘要：
今天有各种各样的神经调节治疗方法，更多的方法正在进行中，但是明天的精神科医生准备将这些工具纳入他们的病人的护理计划吗？这篇文章解决了普通精神病学受训者对临床神经调节培训的需求。为了确保患者获得神经调节治疗，我们认为普通精神科医生应接受一系列神经调节模式的充分教育,以确定潜在的候选人并将神经调节纳入他们的多学科护理计划.我们建议在精神病学实践中目前可用的四种FDA批准的模式中进行课程开发：电惊厥疗法（ECT），经颅磁刺激(TMS),深部脑刺激（DBS），和迷走神经刺激（VNS）。专注于精神病学住院医师培训，这篇文章描述了每种神经调节技术的核心学习组件。对于每种模式，我们回顾了临床培训状况，各自的FDA批准的适应症，行动机制,临床适应症和禁忌症，不利影响，知情同意程序，剂量考虑，和临床管理指南。本文概述的方法旨在为发展全面的一代精神病学受训者做出贡献，这些受训者有能力驾驭不断发展的神经调节领域。无论精神科医生是否专门提供神经调节疗法，所有精神科医生都有责任识别应该接受神经调节治疗的患者，并提供全面的病人护理之前，在临床神经调节干预期间和之后，以优化结果并防止复发。
