97 The rates of response and remission for MST exceeds those reported

for TMS (ie, 15% remission rate) in the treatment of MDD,112,113 but are less than those reported for ECT (eg, greater than 80% for acute course).114,115 With continued development, MST may be able to match the response the remission Inhibitors,research,lifescience,medical rates of ECT, but this will only be important should it also maintain its neurocognitive safety or possible cognitive enhancement properties. Applications of magnetic seizure therapy in vulnerable populations As a hybrid between TMS and ECT, MST is being developed as a neurotherapeutic strategy for the treatment of major affective disorders. Converging preclinical and clinical evidence suggests that MST has benign cognitive effects, and possibly could improve cognitive abilities.91 As such, MST may have applications in vulnerable populations with neuropsychiatric diseases including patients who are elderly or have traumatic brain injury (TBI) or dementia. Inhibitors,research,lifescience,medical Also, given recent findings that TMS does not impact cognitive

functioning in children and adolescents with MDD, MST too could serve a role if it is found to be safe in this cohort (Well et al, personal Inhibitors,research,lifescience,medical communication). In elderly adults and those with TBI or dementia, MST may be able to improve mood-related disorders and cognitive abilities, or at the very least, spare impacting cognitive abilities, thereby Inhibitors,research,lifescience,medical preventing long-term adverse cognitive effects. Neurorehabilitative paradigms may benefit from MST. The comorbidity of MDD with other neuropsychiatric diseases, particularly traumatic brain injury (TBI),116 may prohibit the successful implementation of neurorehabilitative paradigms. While ECT has been found to be useful

to treat Inhibitors,research,lifescience,medical MDD in TBI cohorts, the deleterious cognitive affects could minimize the immediate and beneficial use of neurorehabilitation. Hypothetical, MST and OSI-906 ic50 neurorehabilitation could be delivered concurrently enough such that the patient could experience decreased depression severity while simultaneously benefiting from improved cognitive abilities. Similar types of strategies are employed with combined TMS and neurorehabilitative programs. Extensive work with MST is required to first empirically validate its inclusion in the antidepressant psychiatric armamentarium, and then to further its involvement in therapeutic strategies for vulnerable populations. Continued translational investigations will provide answers to open questions at this time including the effects of MST on neurogenesis, the relationship between neurogenesis and neurocognitive and clinical outcome, and the linkage to functionality.