Transcranial Magnetic Stimulation

Robot-assisted transcranial magnetic stimulation (TMS). Wesley is guiding the robot into the starting position and Courtney is wearing the head tracker. The three-day course offers intensive training on Transcranial Magnetic Stimulation (TMS). TMS is an FDA-cleared treatment for depression, obsessive-compulsive disorder, migraines and smoking cessation. This course is designed for psychiatrists, psychologists and researchers who wish to enhance their knowledge of TMS and related brain stimulation techniques, and includes didactic sessions and hands-on administration of TMS. The didactic sessions cover all topics relevant to running a TMS clinical service and a TMS research lab, including:

Device principles and types; the neuroscience of TMS
Motor threshold determination
Treatment technique
Stimulus dosing
Risks, complications and contraindications
Safety screening
Post-TMS management and continuation treatment
Clinical and non-clinical research applications
Emerging brain stimulation techniques

Learning Objectives

At the conclusion of this course, participants should be able to:

State the rationale for the use of TMS in depression, obsessive compulsive disorder and off-label conditions
Explain regulatory issues and policies concerning TMS
Name the two main components of transcranial magnetic stimulation devices
Operate the TMS device and correctly use it to determine the optimal site and motor threshold
Describe the findings from TMS research in imaging and motor cortex excitability studies
Apply the indications for use of TMS in depression
Identify the risks and side effects of TMS and describe how to conduct a safety screening
Design a protocol for seizure management during TMS administration
Outline steps necessary to set up a TMS service/lab

Schedule, Cost & Registration

The course, currently offered on a quarterly basis, is held on a Saturday from 8:30am to 5pm, Sunday from 8:30 am to 7pm and Monday from 8:30am to 5pm. Attendees must attend all three days of the course in order to receive full continuing education credit for the course.

The 2021 courses are being offered virtually due to COVID-19. The course dates are:

January 23-25, 2021
April 17-19, 2021
July 17-19, 2021
October 16-18, 2021

The cost of the course is $2,700 and the course is capped at 30 participants.

In Fall 2020, we conducted the first virtual version of the course. Learn more about and see photos of this successful virtual event!

Faculty

Greg Appelbaum, PhD

Associate Professor of Psychiatry & Behavioral Sciences

Duke University School of Medicine

Dr. Greg Appelbaum, an associate professor in the Department of Psychiatry & Behavioral Sciences in the Duke University School of Medicine, directs the Human Performance Optimization lab (OptiLab) and the Brain Stimulation Research Center. He is a core member of the Center for Cognitive Neuroscience, holds a secondary appointment in the Department of Psychology and Neuroscience, and teaches graduate and undergraduate students in the Cognitive Neuroscience Admitting Program and the neuroscience major.

Dr. Appelbaum’ s research interests primarily concern neuroplasticity and learning using an assortment of human neuroscience techniques including electroencephalography (EEG), functional magnetic resonance imaging (fMRI), transcranial magnetic stimulation (TMS), and transcranial electrical stimulation (TES). This research is funded by the National Institutes of Health and the Department of Defense with the specific goal of translating basic science knowledge to applications that can improve human behavior and brain health.

Asa Cordle, MD

Partner, Raleigh Psychiatric Associates
TMS Clinic Director

Inspired by an optimism for the clinical applications of neurotechnology, Dr. Asa Cordle has supplemented much of his medical career practicing, teaching or researching brain stimulation modalities in academic and private clinical settings.

While at UNC-Chapel Hill for medical school and psychiatry residency, he trained in ECT and assisted with research in DBS and transcranial current stimulation. He then completed a fellowship at MUSC's Brain Stimulation Service, treating patients and supervising trainees in TMS and ECT. As a psychiatrist at Raleigh Psychiatric Associates, he has treated hundreds of patients with TMS as well as offered more conventional services to general psychiatry outpatients. In addition to neurostimulation, he also has interests in psychotherapy and longevity medicine and continues to train local colleagues in TMS He is excited about the continued progress seen with TMS and brain stimulation in complementing psychiatry's array of therapeutic approaches.

Simon W. Davis, PhD

Assistant Professor, Department of Neurology
Duke University School of Medicine

Dr. Simon Davis received his BA from New College of FL, an MSc in Neuropsychology from University College London, and a PhD in Psychology & Neuroscience from Duke University. His lab at Duke specializes in structural, functional, and causal approaches to the investigation of the dynamics of the normal and demented aging brain.

Leah D. Frymi, MD

Staff Psychiatrist
Durham VA Medical Center

Dr. Leah Fryml earned her MD at the Medical University of South Carolina (MUSC) in Charleston, South Carolina. After graduating, she completed a residency in psychiatry (Interventional Psychiatry Research Track) at MUSC, where, under the tutelage of Dr. Mark George, innovator and pioneer of transcranial magnetic stimulation therapy for depression, she received intensive training in research and clinical applications of rTMS and ECT.

Following residency, she served as the medical director for the Carolina Center for Neurostimulation and interim medical director for the Clinical TMS Service while on the clinical faculty at University of North Carolina-Chapel Hill. In her current role as staff psychiatrist at the VA Medical Center in Durham, NC, she supervises Duke psychiatry residents and trainees while providing inpatient psychiatric and ECT services and working to expand veteran access to interventional treatments, including rTMS, infusions, and intranasal esketamine.

Tommy G. Fu, MD

Psychiatrist
Duke Electroconvulsive Therapy Clinic, Duke Regional Hospital
Duke University Hospital

Dr. Tommy Fu received his BA in biological sciences with concentration in animal physiology from Cornell University and his MD from SUNY Upstate Medical University.

He recently completed his general psychiatry residency at the Medical University of South Carolina in June 2020. During his last year of residency, he was fortunate enough to work extensively with the brain stimulation group at MUSC on clinical services. He also attended MUSC’s Brain Stimulation Intensive Course in 2019 directed by Dr. George. Dr. Fu is trained in both TMS and ECT. He is a member of the Clinical TMS Society.

Dr. Fu is a new faculty member in the Department of Psychiatry & Behavioral Sciences at Duke University School of Medicine/Duke Health. At Duke, his areas of clinical practice include inpatient psychiatry, outpatient psychiatry (student mental health and general adult), and electroconvulsive therapy.

Stefan M. Goetz, PhD

Assistant Professor of Psychiatry & Behavioral Sciences
Departments of Psychiatry & Behavioral Sciences, Electrical and Computer Engineering, and Neurosurgery
Duke University

Dr. Stefan Goetz received BS, MS, and a PhD from Technical University Munich. His research focus is on the neurophysiology and biophysics of brain stimulation and the development of novel technology for neuroscience and clinical brain stimulation.

Colleen A. Hanlon, PhD

Professor
Department of Cancer Biology at Wake Forest University Health Sciences

Dr. Colleen A. Hanlon is a professor in the Department of Cancer Biology at Wake Forest University Health Sciences, where she leads a new Electromagnetic Therapeutics Research Program. The majority of her research is focused on developing evidence-based TMS protocols which may be useful therapeutic tools for patients struggling with addiction. She leads 3 NIH-supported R01 awards and is part of two NIH centers interested in translating preclinical brain stimulation knowledge into a treatment that can be delivered to patients with alcohol and substance use disorders. She was honored with the Early Career Investigator award from the National Institute of Drug Abuse. I am the senior author on the first “Consensus Paper” published by a group of more than 70 scientists from more than 10 countries outlining the path forward for Non-Invasive Therapeutic Development for Addiction.

She participates in the research training and education community at both a local level (serving as a mentor to over 50 medical, graduate, post-graduate, and fellowship trainees since 2005 on a national and international scale) and national level. She has directed the Advanced TMS Training Course sponsored by the National Center for Neuromodulation for Rehabilitation, and continues to be involved in their research dissemination efforts through teaching and management of their social media presence. She has led an annual addiction outreach event at the College of Problems on Drug Dependence (CPDD) meeting (2015-2019), served on the Liaison Committee (2016-2019) and the Education and Training Committee (2019-present) for the American College of Neuropsychopharmacology, Grassroots Advocacy Team for the Society for Neuroscience (2017-2019), Chair of the Education Outreach and Public Policy Committee for CPDD (2017-2019), ad hoc participation in over 20 NIH study sections, and serving as a standing member of NIH NPAS study section (effective 10/2018).

Sarah H. Lisanby, MD

Professor Emeritus
Former JP Gibbons Professor and Chair, Duke
Founding Director, Division of Brain Stimulation and Neurophysiology
Department of Psychiatry & Behavioral Sciences, Duke University

Dr. Holly Lisanby, an internationally renowned innovator of neuromodulation technologies, is Director of the Division of Translational Research at the National Institute of Mental Health (NIMH). As division director, she is responsible for managing a portfolio of approximately $400 Million to support research directed towards the discovery of preventions, treatments, and cures for mental illness across the lifespan. She founded and directs the Noninvasive Neuromodulation Unit in the NIMH Intramural Research Program, a pioneering translational research program specializing in the use of brain stimulation tools to measure and modulate neuroplasticity to improve mental health.

Previously, she held the JP Gibbons Endowed Professorship with Tenure and was the first woman to serve as chair of the Duke University Department of Psychiatry & Behavioral Sciences, a position she held for five years prior to being recruited to the NIMH. She founded and directed both the Duke University and the Columbia University Divisions of Brain Stimulation, where she built interdisciplinary research programs specializing in the convergence of Psychiatry, Neuroscience and Engineering. She co-led the NIH BRAIN Initiative Team focused on large-scale neural recording and modulation devices.

Dr. Lisanby’s laboratory has been continuously federally funded for over 20 years. She has been principal investigator on a series of NIH and DARPA funded studies on the development of novel neuromodulation technologies, including studies on the rational design of magnetic and electrical seizure therapies. Her team pioneered magnetic seizure therapy (MST) as a novel depression treatment from the stages of animal testing, first-in-human, and now international trials.

A prolific author with more than 280 scientific publications, she has received national and international recognition, including the Distinguished Investigator Award from the National Alliance for Research on Schizophrenia and Depression (NARSAD), the Max Hamilton Memorial Prize of the Collegium Internationale Neuro-Psychopharmacologicum (CINP), the Gerald Klerman Award from the National Depression and Manic Depression Association (NDMDA), and the Eva King Killam Research Award from the American College of Neuropsychopharmacology (ACNP).

Dr. Lisanby served on the FDA Neurological Devices Advisory Panel and has held key leadership positions in professional organizations including serving as President of the International Society for ECT and Neurostimulation and Chair of the American Psychiatric Association Task Force to Revise the Practice on Electroconvulsive Therapy (ECT). Dr. Lisanby received her dual BS in Mathematics and Psychology as a recipient of the A. B. Duke Memorial Scholarship. She went on to complete her MD at Duke University, through the Early Identification Program. She completed her psychiatry residency at Duke, where she served as executive chief resident, and a postdoctoral fellowship in Geriatric Psychiatry and Affective Disorders Research at Columbia University.

Bruce M. Luber, PhD

Staff Scientist, National Institute of Mental Health

Dr. Bruce Luber received his PhD in experimental psychology from NYU, researching spatial attention using magnetoencephalopgraphy (MEG). His post-doctorate work at Columbia University/NY State Psychiatric Institute focused on the electrophysiology of memory and of ECT. He joined Dr. Holly Lisanby in the then new field of transcranial magnetic stimulation (TMS) at Columbia in 1995. With Dr. Lisanby and collaborators he researched the cortical mechanisms underlying working memory, conditioned learning, pain, deception, and self-recognition. His primary focus is on the use of TMS to explore executive function and memory, and its applications to geriatric psychiatry and to major depression. He was on the faculty at Columbia University until November 2010 when he moved to Duke University. In 2015, he moved to the NIMH in Bethesda, MD.

Shawn M. McClintock, PhD, MSCS

Associate Professor
Division of Psychology, Department of Psychiatry
UT Southwestern Medical Center

Adjunct Associate Professor
Department of Psychiatry & Behavioral Sciences

Dr. Shawn McClintock received his BA in psychology from the University of North Texas (1998), his MS in Rehabilitation Counseling Psychology (2005), PhD degree in Clinical Psychology (2006), and his MS in Clinical Sciences (2011) from UT Southwestern Medical Center. He completed postdoctoral training in clinical neuropsychology and mood disorders research as a National Institute of Mental Health T32 Postdoctoral Fellow at UT Southwestern Medical Center, and he completed postdoctoral training in brain stimulation and therapeutic modulation at Columbia University / New York State Psychiatric Institute. Dr. McClintock’s program of research has centered around elucidating the mechanisms underlying the neurocognitive effects of major depressive disorder and neuromodulation therapeutics including electroconvulsive therapy (ECT), magnetic seizure therapy (MST), transcranial magnetic stimulation (TMS), and transcranial direct current stimulation (tDCS).

Andrada D. Neacsiu, PhD

Assistant Professor
Director of Behavioral Medicine
Department of Psychiatry & Behavioral Sciences
Department of Family Medicine and Community Health
Duke University Medical Center

Dr. Andrada Neacsiu is a clinical psychologist with a primary interest in outpatient interventions for difficulties managing emotional experiences that interfere with well-being. As a clinician, she specialize in Dialectical Behavior Therapy (DBT) and Cognitive Behavioral Therapy (CBT) for adults who report a variety of mental health problems, including personality, mood, anxiety, eating, trauma, stress-related, adjustment, and impulse control disorders. Her approach to psychotherapy includes working collaboratively with patients to identify their unique life and therapy goals and to implement evidence-based interventions in order to achieve their identified goals.

As an educator, she trains clinicians nationally and teaches Duke graduate students, psychology and psychiatry residents in in how to effectively apply CBT and DBT in their clinical work. She also directs a wellness program in the department of Family Medicine and Community Health.

As a researcher, she focuses on psychotherapy optimization and neuroscience-informed treatment development for emotion dysregulation. Her research keeps her up to date with the latest evidence-based approaches to use in her clinical work, and her work with patients strongly influences the research that she does. Outside of work, she enjoys traveling, gourmet food, nature adventures and time with friends and family.

Angel V. Peterchev, PhD

Associate Professor

Department of Psychiatry & Behavioral Sciences
Division of Behavioral Medicine & Neurosciences
Departments of Biomedical Engineering, Electrical & Computer Engineering, and Neurosurgery (secondary)
Duke University

Dr. Angel Peterchev received an AB degree in physics and engineering sciences from Harvard University in 1999 and MS and PhD degrees in electrical engineering with a graduate-level minor in cognitive neuroscience from the University of California at Berkeley in 2002 and 2005, respectively. He completed postdoctoral training in TMS at Columbia University in 2007, and remained on the faculty there until the end of 2010, when he moved to Duke University. Dr. Peterchev’ s current research focuses on the development and modeling of technology and application paradigms for transcranial brain stimulation, including TMS, electroconvulsive therapy (ECT), magnetic seizure therapy (MST), and the integration of TMS with functional magnetic resonance imaging (fMRI) and electroencephalography (EEG). The ultimate clinical goal of his work is to make transcranial stimulation techniques robustly effective and safe.

Sandeep Vaishnavi, MD, PhD

Medical Director, MindPath Care Centers Brain Stimulation
Program and Medical Director, MindPath Care Centers Clinical Research Institute

Dr. Sandeep Vaishnavi received his MD and PhD from the University of Alabama at Birmingham. He did his residency in psychiatry at Duke University, as well as a Clinical Psychopharmacology residency at Duke University and GlaxoSmithKline. He did his fellowship in behavioral neurology & neuropsychiatry at Johns Hopkins. Dr. Vaishnavi is board-certified in behavioral neurology & neuropsychiatry, as well as general psychiatry. He is the coauthor of The Traumatized Brain (Johns Hopkins University Press, 2015). He is interested in the interface of neurology and psychiatry (mood, behavioral, and cognitive symptoms in neurological disorders, including traumatic brain injury, brain tumor, and stroke). He is also interested in studying and using biomarkers, objective assessments and neuroscience-based treatments for psychiatric disorders.

Ellie Wood

Clinical Research Specialist, Sr.
Department of Psychiatry & Behavioral Sciences, Division of Behavioral Medicine and Neurosciences
Duke University School of Medicine

Ellie Wood recently earned her BSE in Biomedical Engineering with concentrations in Electrobiology and Biomedical Imaging and Instrumentation from Duke University’s Pratt School of Engineering. Ms. Wood serves as a TMS technician for the Duke University School of Medicine’s Brain Stimulation Research Center, where she collaborates with researchers who are looking to explore potential applications of TMS in the fields of psychiatry, neurology and psychology. She also serves as a clinical research coordinator for the Human Performance Optimization lab (OptiLab), which focuses largely on innovative approaches for accelerating and learning and remediating deficits.

Jonathan R. Young, MD

VA Advanced Fellow in Mental Illness Research and Treatment, Mid-Atlantic MIRECC
Research Fellow, Duke Clinical Research Institute (DCRI)
Clinical Associate, Division of Behavioral Medicine & Neurosciences
Department of Psychiatry & Behavioral Sciences
Duke University School of Medicine

Dr. Jonathan Young received his BA in psychology, physics and chemistry from New York University in 2010 and his MD from Stony Brook University in 2016. He completed his residency in adult psychiatry at Duke University Health System in 2020. Dr. Young began working in clinical neuroscience as an undergraduate research assistant under Thomas Thesen, PhD, where he administered functional magnetic resonance imaging (fMRI) and published on the default mode network abnormalities in idiopathic generalized epilepsy.

During medical school, Dr. Young became a visiting graduate student at Duke under Sarah Lisanby, MD where he contributed to mood disorders clinical trials using transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), and electroconvulsive therapy (ECT). As a resident at Duke, he published on novel applications of non-invasive brain stimulation (NIBS) including the treatment of opioid use disorder (OUD) and the enhancement of surgical skills training. During this time he received awards from the Society of Biological Psychiatry (SOBP), International Society of ECT and Neurostimulation (ISEN), and the American Society of Clinical Psychopharmacology (ASCP).

Currently an attending psychiatrist for the Duke ECT program, Dr. Young is also research fellow at the Durham VA Medical Center under the mentorship of Jean Beckham, PhD, and Greg Appelbaum, PhD, exploring the therapeutic application of fMRI-guided TMS for the treatment substance use disorders in Veterans with comorbid psychiatric illness.

Planning Committee/Faculty Disclosure

The following speakers and/or planning committee members have indicated they have no relationship(s) with industry to disclose relative to the content of this CME activity:

Lawrence Appelbaum, PhD
Asa Cordle, MD
Simon Davis, PhD
Tommy Fu, MD
Sarah H. Lisanby, MD
Bruce Luber, PhD
Marisa Spurrell, BA
Jonathan Young, MD

The following speaker/planning committee member have indicated that s/he has relationship(s) with industry to disclose:

Stefan Goetz, PhD, investigator for Magstim. Stock holder in Nervive.
Colleen A. Hanlon, PhD, consultant for Roswell Park Cancer Institute.
Shawn M. McClintock, PhD, MSCS, consultant for X-Pearson Assessment.
Andrada Neacsiu, PhD, has received training fees for teaching mental health providers cognitive behavioral therapy and dialectical behavioral therapy techniques from Behavioral Tech and NC AHECs.
Angel V. Peterchev, PhD, is inventor on patents and patent applications and has received research and travel support as well as patent royalties from Rogue Research, research and travel support, consulting fees, as well as equipment loan from Tal medical, patent application support from Magstim, as well as equipment loans from MagVenture, all related to technology for TMS.
Sandeep Vaishnavi, MD, PhD, employee of MindPath Care Centers, primary investigator for Otsuka, primary investigator for National Institute of Child Health and Human Development, and consultant for the Department of Defense.

Disclaimer

The information provided at this CME activity is for continuing medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition.

Statements by industry representatives during the industry device demos and exhibits may not reflect the views and opinions of the course organizers and faculty.

Credit Designation

Duke University Health System Department of Clinical Education and Professional Development designates this live activity for a maximum of 20.0 AMA PRA Category 1 Credit(s). Physicians should claim only credit commensurate with the extent of their participation in the activity.

Accreditation Statement

Duke University Health System Department of Clinical Education & Professional Development is accredited by the American Nurses Credentialing Center (ANCC), the Accreditation Council for Pharmacy Education (ACPE), and the Accreditation Council for Continuing Medical Education (ACCME), to provide continuing education for the health care team.

Contact Us

To learn more, contact Marisa Spurrell at DukeTMS@dm.duke.edu or 919-681-0935.

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