Developing Multimodal Therapies for Brain Disorders Proceedings of a Workshop (2017) / Chapter Skim
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3 Exploring the State of the Science
3 Exploring the State of the Science
Pages 19-28
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From page 19... ...
, a noninvasive neu rostimulation procedure, can have acute and long-lasting effects on the brain, alleviating depression and enhancing cognitive perfor mance; TMS may provide additional benefits when combined with cognitive stimulation and psychosocial intervention (Luber, Strauman)
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From page 20... ...
The theoretical considerations of seemingly simple approaches -- using two drugs at the same time -- are useful and apply to more complicated multimodal therapies, such as those that coadminister drugs with psychosocial intervention or neurostimulation, added Hildebrand. CO-DELIVERY OF PHARMACOLOGICAL INTERVENTIONS FOR ALZHEIMER'S DISEASE Currently, more than 35 million people worldwide are estimated to have AD, with these numbers expected to triple by 2050 unless an effective treatment is found to slow or prevent the disease (Alzheimer's Association, 2014; Prince et al., 2013)
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From page 21... ...
So a com mbination theerapy co ould potentiallly attack onee pathology inn two differeent ways, attaack two diifferent pathoologies, or attaack one pathoology in com mbination withh a neurop protective ageent. Off course, commbining drugs introduces m many other chaallenges relatted to pharmacokinetics, pharmacod dynamics, dosse finding, dru rug interactionns, and otther adverse events, e said Hendrix.
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From page 22... ...
To advance combination therapy more generally, the workgroup also recommended using transgenic animal models and human neuronal cell culture models to test combinations and using adaptive trials. Ideally, a biomarker that provides a single readout of treatment effect would enable these studies to move forward efficiently, said Hendrix.
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From page 23... ...
Some of these devices are widely available from retail outlets, including those that measure galvanic skin response or sense bed shaking and other atypical movements. Morrell described a device she has been working with that combines sensing with responsive neurostimulation, which was approved by the FDA for treatment of uncontrolled partial-onset seizures after 12 years of clinical trials.
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From page 24... ...
. Chang said he hopes the combination of targeted pharmacologic plus psychotherapy at a critical time in brain development will restore healthy neuronal connectivity and function in these at-risk children.
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From page 25... ...
This approach, called Cognitive Paired Associate Stimulation (C-PAS) , is based on the original PAS technique, which combined peripheral stimulation of the median nerve in the hand with TMS to increase excitability changes in the motor cortex and thus potentially increase the therapeutic potential (Ridding and Taylor, 2001)
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From page 26... ...
Strauman described preliminary clinical data obtained from five people during early trials, using both clinician report and patient selfreport. These early results, which require further validation, suggest that patients who receive the combination treatment showed improvements in depressive symptoms in a shorter period of time than would be seen in response to typical monotherapy approaches, said Strauman.
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From page 27... ...
Another study supported by NCCIH incorporates mindfulness meditation for the treatment of pain and demonstrates that mindfulness meditation does not rely on the endogenous opioid activity to reduce pain, since naloxone administration did not block meditation's pain-relieving effects -- an important consideration for using meditation to treat chronic pain and reduce opioid use, said Edwards.
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