I found these articles on TMS in the German litterature.

Scott

Der Nervenarzt

ISSN: 0028-2804 (printed version)
ISSN: 1433-0407 (electronic version)

Table of Contents

Abstract Volume 68 Issue 3 (1997) pp 274-278

Transkranielle Magnetstimulation (TMS) Ein Diagnostikum aus der
Neurologie als
Therapeutikum in der Psychiatrie?
Transcranial magnetic stimulation (TMS). A diagnostic tool from
neurology as a therapy in
psychiatry?

C. Haag, F. Padberg, H. J. Möller

Psychiatrische Klinik (Direktor: Prof. H. J. Möller) der
Universität, München

Zusammenfassung Die transkranielle Magnetstimulation (TMS) ist
ein Verfahren, das seit nunmehr einer Dekade in der neurologischen
Diagnostik zur
Untersuchung der motorischen Bahnsysteme routinemäßig
eingesetzt wird. Aus dieser Zeit ist die TMS bezüglich der Sicherheit
in der Anwendung am
Menschen gut untersucht und hat sich als sicher und
nebenwirkungsfrei erwiesen. Seit wenigen Jahren wird die Möglichkeit
untersucht, mittels der TMS
nichtinvasiv tiefere Hirnregionen elektrisch zu stimulieren und
so, in Analogie zur Elektrokrampftherapie, eine antidepressive Wirkung
zu erzielen. Dies hätte
große Vorteile, da dieses Verfahren schonend und ohne Narkose
angewendet werden kann. Mehrere Einzelfallanwendungen, aber auch schon
mehrere
klinisch kontrollierte Studien lassen z. Z. die begründete
Hoffnung zu, daß dieses Verfahren zu einer Erweiterung des Spektrums
antidepressiver
Behandlungsverfahren führen könnte.

Summary Transcranial magnetic stimulation (TMS) has been used
since a decade to investigate the central motor system in the
neurological routine
diagnostic. From this experience TMS has prooved to be a save
and well tolerated procedure. In the past few years several studies
investigated TMS to
electrically stimulate deeper brain regions to find
antidepressive effects in analogy to electro convulsive therapy (ECT).
This could be of great advantage as
TMS is well tolerated and does not require general anesthesia.
There have been some case reports and also some controlled clinical
studies on TMS as a
therapeutic tool. The results of these studies have been
promising. Many questions regarding technical and clinical aspects
remain to be answered. In the
future however TMS could be a valuable addition in the
treatment of depression.

Schlüsselwörter Transkranielle Magnetstimulation ·
Elektrokrampftherapie · Depression · Therapie

Key words Transcranial magnetic stimulation · Electro
convulsive therapy · Depression · Treatment
=

Acta Neurochirurgica

ISSN: 0001-6268 (printed version)
ISSN: 0942-0940 (electronic version)

Table of Contents

Abstract Volume 134 Issue 3-4 (1995) pp 184-189

Endosaccular Occlusion of Basilar Artery Bifurcation
Aneurysms
Using Electrically Detachable Coils

G. Bavinzski, B. Richling, A. Gruber, M. Killer, and D. Levy

Summary: Thirteen patients with basilar artery bifurcation
aneurysms, treated by electro thrombosis
usingelectrically detachable coils, are presented. Nine of
them presented after hemorrhage, two with mass
effect, and two were found coincidentally with other ruptured
aneurysms. Selection for endovascular therapy
was based on the following criteria: 1) poor clinical
condition (Hunt and Hess III-V); 2) high surgical risk; 3) age
and poor medical condition; 4) morphological features (small
necked aneurysms). With endovascular Guglielmi
detachable coils aneurysm occlusion ranging from 70-100% was
achieved in all cases. All five small necked and
two large broad necked aneurysms were totally occluded. Two
large aneurysms had a 95% occlusion and two
other large aneurysms were 90% occluded. In another patient
with a large broad based aneurysm only an 80%
occlusion was achieved, because of tortuosity of the
vertebrobasilar system. Our last patient, who presented as
grade V clinically, was partially treated with a 70%
aneurysmal occlusion. The clinical results were excellent in
10 and good in 2. The only poor outcome was seen in the grade
V patient. There was no morbidity or mortality
related to therapy. The only complication was an asymptomatic
dissecting aneurysm at the origin of the
vertebral artery. Angiographic follow up time ranged from 6
to 20 months with a mean of 9 months. Four
patients were treated too recently to have their angiographic
follow up at 6 months. Two patients were lost to
follow up. Clinical follow up ranged from 1 to 17 months with
a mean of 8.9 months. The analysis of our cases
clearly shows that aneurysms, which were densely packed with
coils, especially if small necked, were less likely
to be reperfused and showed a longlasting stable result.
Large broad based aneurysms were more likely to be
reopened by blood flow after the first procedure, especially
if loosely filled with coils, and needed up to 3
interventions to achieve asatisfying result, where as later
in the series a high percentage rate of occlusion was
seen after the first procedure. We consider now also a less
than 100% occlusion acceptable, because most of
the aneurysms will rupture at the dome, which was occluded in
all our cases. We conclude, that this new
endovascular method is a viable alternative in the treatment
of posterior circulation aneurysms with a high
surgical risk, in old patients and those in poor clinical and
medical condition.

Keywords: Aneurysms; basilar artery; detachable coils.

Article not available online

Der Nervenarzt

ISSN: 0028-2804 (printed version)
ISSN: 1433-0407 (electronic version)

Table of Contents

Abstract Volume 72 Issue 9 (2001) pp 734-738

ergebnisse & kasuistik: Repetitive transkranielle
Magnetstimulation (rTMS) in der Akut- und
Langzeittherapie bei therapieresistenter Depression
Eine Falldarstellung
Reptitive transcranial magnetic stimulation (rTMS) in acute and
long-term treatment of
therapy-resistant depression - a case report

S. Smesny (1), H. P. Volz (1), J. Liepert (2), R. Tauber (1),
A. Hochstetter (3), H. Sauer (1)

(1) Klinik für Psychiatrie der Friedrich-Schiller-Universität
Jena
(2) Klinik für Neurologie der Friedrich-Schiller-Universität
Jena
(3) Klinik für Neurochirurgie der
Friedrich-Schiller-Universität Jena

Zusammenfassung Berichtet wird über eine Patientin mit
schwerer, therapieresistenter depressiver Episode bei rezidivierender
depressiver Störung
(ICD-10: F33,3), die sich innerhalb der vergangenen 7 Jahre
insgesamt 60 Monate in stationärer Behandlung befand. Fünf
Elektrokrampftherapie
(EKT)-Serien (insgesamt 61 Behandlungen) führten zu
kurzzeitigen Stimmungsaufhellungen, blieben jedoch längerfristig ohne
Erfolg. Außerdem wurden
zunehmende kognitive Defizite und prolongierte postnarkotische
Aufwachphasen beobachtet, sodass weitere Behandlungen kontraindiziert
waren. Als
alternativer Behandlungsansatz erfolgte die repetitive
transkranielle Magnetstimulation (rTMS) über dem Gyrus frontalis
superior links unter Verwendung
eines Neuronavigationsverfahrens. Im Verlauf wurde der
psychische Befund anhand standardisierter Ratings (HAMD [1], BDI [2])
kontrolliert. Die
kognitive Leistungsfähigkeit wurde im Langzeitverlauf erfasst.
Bereits nach wenigen rTMS-Behandlungen zeigte sich eine
Befundverbesserung mit
Stimmungsaufhellung, Distanzierung von depressiven Wahninhalten
und Zunahme von Außenaktivitäten, sodass nach 4 Wochen täglicher
Behandlung die
Entlassung erfolgte. Durch ambulante Erhaltungsbehandlungen und
verhaltenstherapeutische Interventionen wurde eine kontinuierliche,
familiäre und soziale
Reintegration möglich.

Summary We report on a patient with therapy-resistant major
depression according to DSM-IV criteria who has been hospitalized for
60 months during the
last 7 years. Not even five electroconvulsive therapy (ECT)
series (61 single applications) brought lasting remission of symptoms.
As cognitive deficits
developed and prolonged postnarcotic recovery times were
observed, further ECT was contraindicated. The left frontal cortex was
chosen as the target site
for repetitive transcranial magnetic stimulation (rTMS)
treatment. For identification, a neuronavigational system was used
that allows online monitoring of the
position of the magnetic coil in relation to the individual
cortex. The therapeutic progress was monitored by standardized
psychiatric ratings (HAMD, BDI).
In addition, cognitive performance was tested during the course
of treatment. Only a few rTMS applications already caused an obvious
brightening in mood,
remission of depressive delusional symptoms, and an increase in
personal interests and activities. After 4 weeks of daily treatment,
the patient was discharged
from the ward. The rTMS treatments and psychotherapeutic
counseling have been continued on an outpatient basis. Thus, pharmaco-
and psychotherapeutic
interventions combined with rTMS led to persistent symptom
remission and social reintegration.

Schlüsselwörter Depression · Therapieresistenz · rTMS

Keywords Therapy-resistant depression · rTMS