[Transcranial magnetic stimulation versus electroconvulsive shocks: neuroanatomical investigations in rats]. / Przezczaszkowa stymulacja magnetyczna a zabiegi elektrowstrzasowe--badania neuroanatomiczne u szczura.

Since the time of introducing ECT to the clinical practice, the method always raised questions regarding possibility that the current running through structures of a brain may evoke structural changes and, as a result, evoke convulsive attacks. Pathological changes (swelling, gliosis, atrophy, necrosis) were observed most often after "mega"--schemes including series of several to several hundred ECT treatments. Regime used nowadays including only 8-12 ECT sessions seems to be entirely safe. There are, however, only a few experimental works dealing with this problem. In 1992 research started on a new neurophysiological technique--transcranial magnetic stimulation (TMS) in depression. The advantage of this method is that is does not seem to evoke convulsive attacks. Prolonged rapid rate TMS (rTMS) seems to be particularly efficient in treatment of depression. Despite thousands of works describing various functional effects of TMS, there are obviously no researches on structural effects of the technique. In the case of experimental research on animals a few works were published and their results seem to be ambiguous. We have examined the influence of prolonged repetitive rTMS (B = 1.4 T, t = 5.5 min, f = 30 Hz), and standard ECT (I = 150 mA, t = 0.5 s, f = 50 Hz) on the structure of brain tissue in rats. Both groups of animals (n = 10) received 12 stimulation sessions. After the treatment the animals were routinely processed for electron microscopy (EM) and for light microscopy (LM). Our investigations suggest that the technique of ECT shows a considerable neurotoxic potential. In comparison to ECT--the rTMS method seems to be more safe.

[The behavioral effects of the transcranial magnetic brain stimulation in rat: the comparison with electroshock]. / Efekty behawioralne przezczaszkowej stymulacji magnetycznej (rTMS) u szczura: porównanie z zabiegami elektrowstrzasowymi.

The few experimental studies suggest that repetitive rapid-rate transcranial magnetic stimulation (TMS) evokes in the brain functional and structural changes similar to those evoked by electroconvulsive therapy (ECT). The aim of the present work was to compare the influence of the repetitive TMS (B = 1.6 T; f = 20 and 30 Hz; t = 5 and 5.5 minutes; N = 9 and 18 days) and that of ECT (I = 150 mA; f = 50 Hz; t = 0.5 s; N = 9 days) on rats' behaviour in the tests of free field, tail flick, motor hyperactivity after administration of apomorphine and in forced swimming. None of the rats subjected to TMS suffered from convulsive attack, which followed every electroconvulsive shock. In the free field test it was detected that neither TMS nor ECT applied individually or repetitively disturbed general motor activity of rats. Repetitive electroconvulsive shocks caused analgesia, prolonging the latency of tail flick by 46% (p < 0.001). Moreover, the tail flick test revealed hyperalgesia in the rats subjected to TMS (24 and 21% of control values respectively; p = 0.05). Motor hyperactivity of rats stimulated with administration of apomorphine was intensified both by TMS (by 58% at maximum in the 30th minute of the experiment; p = 0.001) and, all the more, by ECT (by 92% at maximum at the end of the test; p = 0.01). In the forced swimming test, the greatest decrease of inertia period was observed ECT--up to 50% of control values (p = 0.001). TMS had weaker effects--the decrease amounted to 29% of control values (p = 0.01). The shortening effect depended on the parameters of TSM. The obtained results seem to confirm that TMS, like ECT, evokes in rats certain reactions suggesting its antidepressive action, but causes less undesirable effects.

Comparison of effectiveness of two schedules of rapid transcranial magnetic stimulation on enhancement of responsiveness to apomorphine.

Locomotor response to apomorphine (0.5 mg/kg s.c.) was tested in rats pre-treated with multiple rapid transcranial magnetic stimulation (rTMS) or electroconvulsive shock (ECS). rTMS (B = 1.6T, f = 20 Hz, t = 300 s) was delivered 9 times during 18 days (group rTMS1, total number of stimulations 54,000) or 18 times during 18 days (group rTMS2, total number of stimulations 108,000); ECS (I = 150 mA, f = 50 Hz, t = 500 ms) was delivered 9 times at 48 h intervals. Apomorphine given 24 h after the last treatment induced hyperactivity that was significantly more pronounced in rats receiving ECS and rTMS. The effect was most pronounced for electroconvulsive treatment, the least in the rTMS1 group. The results indicate that an increase in the total number of impulses during the rTMS may increase the responsiveness of rats to dopaminergic stimulation to the level comparable with that induced by ECS.

[ECT versus transcranial magnetic stimulation (TMS): preliminary data of computer modeling]. / Zabiegi elektrowstrzasowe a technika przezczaszkowej stymulacji magnetycznej: wstepne wyniki modelowania komputerowego.

The essential issue of electroshock therapy (ECT) is the activity of physical stimulus, i.e., the electric current, on the disturbed structures of the brain. ECT sessions--when chronically applied for evoking antidepressive effects--are responsible for the appearance of excessive incitement in the neuronal net in the brain tissue in a form of self-sustaining after-discharge (SSAD) (convulsive attack characteristic for ECT). The study presents the computer research on basic biophysical phenomena of electroshock therapy (flow of electric current in the structures of the head just before convulsive attack). Five-layer 3-D model of the head was created in OPERA-3D (Vector Fields Ltd., Oxford), general 3 dimensional issues solver. Geometrical dimensions and electrophysical properties of each layer correspond with natural properties. The model was subjected to the action of electric stimulation (parameters identical to those applied in clinical conditions). Analysis of the flow in particular layers revealed the crawling/spreading effect present not only in the scalp layer but also in the layer of cerebrospinal fluid. The effect is conditioned by "deeper situated" lesser conduction of electricity-respectively skull bones, brain tissue. Crawling effect is the reason why only 5-15% of the electricity applied on the surface of the head reaches the surface of the brain. Electro-stimulation examinations also showed that the values of the so called density of the current in layers of brain tissue balanced between 1-10 mA/mm2. The current parameters of ECT were effective in evoking subsequent convulsive attack and safe for the brain tissue. The model was subjected to the action of magnetic stimulation according to the parameters of neurologic technique of transcranial magnetic stimulation (TMS). ELECTRA module was used to solve wire-current issues. The examination showed more regular distribution of current vectors in all layers of the head. The density of cerebral cortex was 0.1-1 mA/mm2, confirming markedly lesser current charge than that observed during ECT. The problem of magnetic stimulation efficacy in irritating deep structures of the brain demands further studies.

[Epidemiological studies on neurotic disturbances, anxiety and depression disorders in a population living near an overhead high voltage transmission line (400 kV)]. / Badania epidemiologiczne nad rozpowszechnieniem zaburzen nerwicowych oraz leku i depresyjnosci wsród osób zamieszkujacych w poblizu linii elektroenergetycznej 400 kV.

Epidemiological studies indicate an increased incidence of depression and neurotic disorders in persons long exposed to influence of electromagnetic fields. The examinations covered a selected population of several suburban neighborhoods of Cracow living not farther than 50 m from a 400 kV high-voltage transmission line. A group of 70 persons (35 men and 35 women) living near the transmission line for longer than 10 years was examined. A control group consisted of 37 persons not subjected to an influence of similar transmission line. Instruments used in the examination included: Symptom Checklist "0", Spielberge's Self-assessment Questionnaire and Beck's Inventory. Also, a modified life-history questionnaire was applied. In the examined households we found significantly increased values of intensity of the electric component (by the so-called "ecological" Swedish norms). The population resident in the closest neighborhood of the examined transmission-line manifested high level of psychopathology, significantly different than that in the control group. However, the obtained results do not allow us to state univocally whether the observed psychopathology remains in causal nexus with the exposure to electromagnetic field. Other factors, like noise, may also be responsible for these results. The hypothesis that electromagnetic fields generated by high-voltage transmission lines may evoke depressive disorders and depression requires further clinical and experimental studies.

Preliminary comparison of behavioral and biochemical effects of chronic transcranial magnetic stimulation and electroconvulsive shock in the rat.

To confirm the assumption that repetitive rapid-rate transcranial magnetic stimulation (TMS) induces the functional and structural changes analogous to those which are evoked during electroconvulsive shock (ECS), we compared now the effects of treatments with TMS and ECS on the behavioral responses in rats. We also tested the reactivity of the cyclic adenosine monophosphate (AMP) generating system in cerebral cortical slices. TMS similarly to ECS shortened the immobility time in the forced swimming test and produced a depression of responsiveness of the noradrenaline-stimulated cyclic AMP generating system, although the significance of the latter effect was borderline. In contrast to ECT, TMS produced no such immediate behavioral effects as analgesia and depression of the early phase of locomotor activity. The data suggest that TMS produces in rats some responses that are regarded as predictive for antidepressant activity, similar to those produced by ECS, but less adverse effects.

[Neurotic disturbances, depression and anxiety disorders in the population living in the vicinity of overhead high-voltage transmission line 400 kV. Epidemiological pilot study]. / Zaburzenia nerwicowe oraz poziom depresyjnosci i leku wsród osób zamieszkujacych w poblizu linii przesylowej 400 kV. Wstepne wyniki badan epidemiologicznych.

Numerous reports suggest a relationship between the increased incidence of depressive and neurotic symptoms in humans and the exposure to extremely low frequency electromagnetic field (EMF) at the place of residence. Our study was conducted in one of the Cracow suburbs with low socio-economic status, adjacent to an easement containing two 400 kV high-voltage transmission lines (distance up to 50 m from the line). The population investigated comprised 70 persons (35 males and 35 females). This group was exposed to EMF from 1986. A control group (n = 37), non-exposed to EMF, was also tested. The EMF intensity was measured by special devices. The following assessments instruments were used: Anamnestic Data Questionnaire, Neurotic Symptoms Questionnaire "O" Spielberger Self-Rating Questionnaire, and Beck-Self-Rating Scale. The measurements of the electric field levels taken at the front walls of investigated buildings averaged much higher than normal values of safety exposure. Our investigation showed the increased psychopathological values in all clinical tests. The difference between the group exposed to EMF and the control population was statistically significant. The results of our study did not support a possible cause-and-effect relationship between EMF and psychopathology observed. Some other factors (noise) can be responsible for the data obtained. The hypothesis that EMF produced by external electric power lines may enhance the occurrence of neurotic symptoms and depression, requires further clinical and experimental investigations.

[Behavioral and biochemical effects of magnetic brain stimulation and electroshock in rats]. / Behawioralne i biochemiczne efekty stymulacji magnetycznej mózgu i elektrowstrzasów u szczurów.

It was proposed that the repetitive rapid-rate transcranial magnetic stimulation (TMS) induces the functional and structural changes analogous to those which are evoked during the electroconvulsive treatment. Presently, we compared the effects of 8 daily treatments with TMS (t = 5 min, B = 0.1 T, trise = 200 microseconds, f = 50 Hz) and electroconvulsive shock (ECS) (t = 0.5 s, I = 150 mA, f = 50 Hz) on the behavior of rats in the forced swimming test (24 h after the last treatment), the exploratory activity test (0-10 min), the basal locomotor activity test (11-30 min), and the tail flick test (2 h after the last treatment). We also tested (24 h after the treatment) the reactivity of the cyclic AMP generating system in cerebral cortical slices. Statistical significance of the results was estimated by ANOVA and t-Student test. The immobility time in the forced swimming test was shortened after TMS and ECS to 86 and 75% of control values, respectively (p < 0.05 and p < 0.01). Both ECS and TMS depressed the basal locomotor activity (by 60 and 80%, resp.), and ECS, but not TMS, diminished also the exploratory activity by 70% (p < 0.01) only ECS induces analgesia, prolonging tail-flick latency by 90% (p < 0.01). ECS diminished the accumulation of the noradrenaline-stimulated cyclic AMP in the cortex slices (by 35%; p < 0.05). The effect after TMS was similar but statistically not significant (87% of control values). The data suggest that TMS produces in rats some responses that are regarded as predictive for the antidepressant activity, similar to those produced by ECS, but less side effects.

[Magnetic brain stimulation in treatment of depression: the search for effective parameters of stimulation]. / Magnetyczna stymulacja mózgu w leczeniu depresji: w poszukiwaniu efektywnych parametrów stymulacji.

Transcranial magnetic stimulation seems to evoke an antidepressant effect similar to that of electroshocks. This effect, however, is not accompanied by convulsions. This technique may be regarded as an alternative method of treatment of depression. It may prove as effective as electroshock treatment, but induce no negative phenomena connected with electro-convulsive treatment. Effectiveness of magnetic stimulation depends on selection of physical parameters of the applied magnetic field. In our model the optimum parameters of transcranial stimulation are: magnetic field induction B < or = 2 T stimulation frequency f [symbol: see text]¿50-100 Hz¿ time of single impulse twide [symbol: see text]¿0,1-1 ms¿ time of impulse rise trise [symbol: see text]¿(10)50-200 microseconds¿ time of impulse decline tdecline [symbol: see text]¿(100)200-1000 microseconds¿ total stimulation time ttotal > or = 1 min repetition rate repetition rate = 8-12

[Transcranial magnetic stimulation neurophysiological and biochemical response in man]. / Ocena neurofizjologiczna i biochemiczna mózgowia poddawanego przezczaszkowej stymulacji magnetycznej.

Ten adult volunteers had EEG recordings and serial serum prolactin/cortisol estimations performed during repetitive transcranial magnetic stimulation. No significant changes in either the hormone values or in the EEG traces were detected.

[The world of computer games I: a new entertainment medium and new danger. Description of a technique]. / Swiat gier komputerowych I--nowe medium rozrywkowe i nowe zagrozenia. Opis techniki.

The paper presents a psychiatric description of the phenomenon of computer games as a new entertainment medium. The possibilities and impedences of this technique are described.

[The world of computer games II: a demographic study on prevalence of computer players in secondary school students]. / Swiat gier komputerowych II--badania ankietowe nad ich rozpowszechnieniem wsród mlodziey szkól srednich.

The article presents the results of the first stage of our own research on the popularization of computer games among adolescents. A questionnaire was filled by 2678 class one pupils of secondary schools (born in 1979). The investigations were aimed at selecting a group of secondary school pupils particularly interested in computers and computer games. The investigations proved that the problem of computer games playing regards more than a half of the school pupils population we examined. There are twice as many boys as girls among the computer games players. Also, boys have better knowledge of computer games, they start to play at a younger age, devote more time to playing these games. The most popular hardware are Amiga or IBM compatible PCs. As many as 3/4 of computer games players have their own computers. The most significant information was the data concerning the time devoted to playing, both daily and weekly. The investigations show that boys spend much more time playing computer games than girls do. The selected group of pupils will undergo detailed clinical as well as psychological examination.

[Can psychiatric examination be useful in early diagnosis of intracranial expansion processes?]. / Czy badanie psychiatryczne moze byc pomocne we wczesnej diagnostyce sródczaszkowych procesów rozrostowych?

The authors carried out pilot investigations of the role of basic psychiatric examination, paying special attention to psychiatric evaluation of anamnestic data in the early recognition of intracranial expansion processes (intracranial tumors). The investigations show that psychiatric diagnostic is not sufficiently effective in the case of intracranial tumors. Despite rich symptomatology of the advanced disease processes, the early symptoms are ambiguous and "litle alarming". What occurs earlier is the "strong" neurological symptoms that can be verified with the use of more and more accessible techniques (mainly neuropicturing).

[Repetitive transcranial magnetic stimulation: EEG, serum prolactin and cortisol studies in humans]. / Stymulacja magnetyczna mózgu: wplyw na zapis EEG oraz wydzielanie prolaktyny i kortyzolu--badania kliniczne.

Ten adult volunteers had EEG recordings and serial serum prolactine/cortisol estimations performed during repetitive transcranial magnetic stimulation. No significant changes in either the hormone values or in the EEG traces were detected.

[Complex treatment techniques for mentally retarded adults]. / Kompleksowy model terapii osób uposledzonych umyslowo.

The authors, a psychiatrist and a psychologist, took part, practically from the very beginning, in organization of a Social Care Home. They also exerted certain influence on elaboration and realization of the programme of complex treatment of mentally retarded persons. The authors present their experiences in application of such complex therapy. They also describe the new therapeutic technique realized in the so-called World Experience Halls, as particularly deserving introduction to treatment practice.

[Ethical, legal and medical problems concerning ECT administration]. / Problemy etyczno-medyczne i prawne zwiázane ze stosowaniem elektrowstrzsów.

Electroconvulsive treatment is a serious and effective biological therapy of current psychiatry which is associated with a certain risk. Treatment with ECT creates a series of problems of a ethico-moral nature which may be solved only in part by the gaining of informed consent of the patient for the treatment procedure. The procedure of gaining "informed consent" in relation to ECT ought to find its regulation in specific acts of the law. The problems concerned with ECT as with other problems in psychiatry should be demistified and become an element of general knowledge available to the whole of society.

[Emission of electromagnetic radiation from selected computer monitors]. / Emisja promieniowania elektromagnetycznego wybranych monitorów komputerowych.

The emission of electromagnetic fields from computer monitors was analysed. The data were compared with the permissible exposure level. EM radiation of chromatic monitors is higher than that of monochromatic ones. The radiation of magnetic fraction is insignificant. Both electric and magnetic fractions of EM radiation, 50 cm away from the monitor, are very low and do not exceed permissible values. It was observed that screen filters were effective in suppressing EM emission only at a short (up to 30 cm) distance from the monitor. At a distance of 50 cm they proved to be ineffective. Metallic-net filters were more effective than glass filters in suppressing EM radiation. It seems that EM fields generated by computer monitors are not harmful to computer operators if the distance is kept in safe limits.

Deep magnetic brain stimulation--the end of psychiatric electroshock therapy?

The biophysical processes during electroconvulsive therapy (ECT) are discussed. The multilayer head structure causes a shunting and spreading of the major portions of the current all over the extracranial tissues. The final effect is that only a small percentage of the injected current passes into the brain. The second 'side effect' of the ECT is the electrical overstimulation of the cortex layer, with self-sustained after-discharge causing convulsive seizure. Therefore, the stimulus transmission into the neurochemically and physiologically disturbed meso-diencephalic region is the most important problem. The stimulation of the brain with rapid-rate time-varying magnetic field pulses makes this problem soluble. The magnetic field passes through all head structures with no attenuation and can stimulate the brain without discomfort. Our calculations of stimulus parameters have assumed that this inductive method may be able to evoke the same therapeutic effects as ECT, but in a safer way (painless, noninvasive and without motor seizure).

[The technique of virtual reality: a new tool in research of the productive symptoms in psychiatry]. / Technika "virtual reality"--nowym narzedziem do badania objawów wytwórczych w psychiatrii?

The author presents the possibilities of the new computer technique of "virtual reality". It causes a nearly perfect "deception" of the central nervous function of the realising judgement and can be a tool in research among others into the perception and its disturbances, especially into the productive symptoms in psychiatry.

[Will electroconvulsive therapy induce seizures: magnetic brain stimulation as hypothesis of a new psychiatric therapy]. / Czy terapia elektrowstrzasowa musi byc "wstrzasowa"--hipoteza stymulacji magnetycznej mózgu jako nowej terapii psychiatrycznej.

This study presents a hypothesis of a new psychiatric therapy. Deep, low-rate transcranial magnetic stimulation is theoretically able to evoke the same therapeutic effects as electro-convulsive therapy but in a softer mode/painlessly and without a motor seizure.