2014 Brain Stimulation Intensive Course

March 24, 2014 to March 28, 2014

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At the conclusion of this activity, participants should be able to: * Review and apply knowledge of past and current brain stimulation research in order to provide optimal care. * Describe the full range of current methods of brain stimulation and be able to list and describe how they differ in their approach to stimulation the brain. * Discuss the TMS (or ECT if ECT track) literature, the latest techniques, the appropriate clinical uses and guidelines and apply this to patient care. * Apply hands-on practice in device set-up and motor threshold determination. * Identify current Safety Guidelines and be able to respond to a patient crisis during TMS. * Be able to select the appropriate patients who meet criteria or are good candidates for treatment. * Complete a written test and accomplish a 70% passing grade/score and then discuss incorrect are as of test with Dr. George

Credit Designation The Medical University of South Carolina designates this live educational activity for a maximum of 32.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Accreditation The Medical University of South Carolina is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. Disclosure In accordance with the ACCME Essentials and Standards, anyone involved in planning or presenting at this educational activity will be required to disclose any relevant financial relationships with commercial interests in the healthcare industry. This information will be made available to participants at the beginning of the activity. Speakers who incorporate information about off-label or investigational use of drugs or devices will be asked to disclose that information at the beginning of their presentation.

Mark S. George, MD

Distinguished Professor Psychiatry, Radiology & Neurology, Director, Brain Stimulation Laboratory Editor-in-Chief E. Baron Short, MD, MS

Associate Professor, Medical Director of Brain Stimulation Xingbao Li, MD

Associate Professor Jeffrey J. Borckardt, Ph.D.

Associate Professor of Psychiatry, Behavioral Sciences, Anestesia, and Perioperative Medicine Colleen A. Hanlon Ph.D.

Assistant Professor

This comprehensive certification course covers the exciting new field of brain stimulation, beginning with the basics of electricity in the brain and then proceeding through with insightful lectures on all of the modern techniques (ECT, TMS, tDCS, DBS, and more). Morning lectures by MUSC faculty are followed by afternoon hands on training and practice. The core course can be done in 3 days, but ‘gunners’ can stay for 5. We encourage both clinicians and researchers planning to use the tools to enroll. The cross talk is usually very exciting. This unique course is structured to allow you to select the most relevant practical sessions for your needs. The course is open to physicians, nurses, researchers and other professionals and trainees, from the U.S. and abroad.

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Location: Institute of Psychiatry, 5th Floor Room 526 North Monday March 24, 2014 8:00 - 8:30 Welcome, Registration &Continental breakfast

Objective: To orient attendees to the general outline of the course, where the rooms are, where support staff are, how to connect to Wi-Fi, and answer any questions they might have about the logistics of the course.

8:30 - 9:00 Historical perspective Mark S. George, M.D. Objective: To recall a historical overview of the development of brain stimulation methods in neurology and psychiatry.

9:00 - 10:15 Physics of TMS Mark S. George, M.D. Objective: Describe the basic units and theory of electromagnetism, and review how the different methods actually interact with the brain to cause stimulation.

10:15 - 10:30 Coffee break Objective: Ask informal questions of faculty

10:30 - 11:45 Neurophysiology of TMS Colleen Hanlon, Ph.D. Objective: Review how TMS can be used to assess the state of cortical excitability of a patient, and compare groups of patients or the same patients before and after different interventions.

11:45 - 1:00 Safety concerns with TMS Mark S. George, M.D. Objective: Explain all of the known side effects of TMS and the safety concerns. Particular emphasis will be on understanding how frequently side effects occur, and then how to clinically manage them. They will be shown video examples of seizures or syncope and will realize how hard it is to clinically distinguish these.

1:00 - 2:30 Lunch (provided) 2:30 - 5:00 Hands-On TMS Small Groups TMS training

Objective: Observe the different TMS machines and identify how to correctly find the motor cortex, and then practice these.

5:00 Adjourn- Complete and Submit all CME forms

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Tuesday March 25, 2014 8:00 - 8:30 Continental breakfast

Objective: Orient attendees to the general outline of the course, where the rooms are, where support staff are, how to connect to Wi-Fi, and answer any questions they might have about the logistics of the course.

8:30 - 10:15 Neuropsychiatric Application of TMS Mark S. George, M.D.

Objective: Review the current literature on the clinical use of TMS, importantly distinguishing what is FDA approved or not, and what has class I evidence or not.

10:15 - 10:30 Coffee break Objective: Ask informal questions of faculty

10:30 - 12:00 Mechanisms of Actions Colleen Hanlon, PhD Objective: Describe brain imaging, and what TMS is doing in the brain at a systems level.

12:00 - 1:00 Case study and Research design Objective: Ask to revisit particular clinical applications of TMS, or to have their own ideas for using TMS in clinical or research settings reviewed by the faculty and other students.

1:00 - 2:30 Lunch (provided) 2:30 - 5:00 Hands-On TMS Small Groups and test

Objective: Practice the hands on skills that were introduced on day 1. Demonstrate hands on progress of competence. If students show adequate progress, they can ask to have the clinical test during this time.

5:00 Adjourn

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Wednesday March 26, 2014 8:00 - 8:30 Continental breakfast

Objective: To orient attendees to the general outline of the course, where the rooms are, where support staff are, how to connect to Wi-Fi, and answer any questions they might have about the logistics of the course.

8:30 - 10:15 Neuropsychiatric Application of TMS/tDCS Jeff Borckardt, Ph.D.

Objective: Discuss current brain stimulation research, treatment approaches, and cortical targeting strategies for chronic and acute pain as well as for problem eating behaviors and other psychiatric conditions.

10:15 - 10:30 Coffee break Objective: Ask informal questions of faculty

10:30 - 12:00 Update and advances with ECT Baron Short, MD Objective: Participant should be able to describe ECT mechanisms, clinical indications, patient selection, mechanisms of action, and current clinical research innovations with ECT.

12:00 - 1:00 Case study and Research design Objective: Seek additional knowledge by asking in-depth questions, to revisit particular clinical applications of TMS, or to present their own ideas for using TMS in clinical or research settings and receive feedback from the faculty and other students.

1:00 - 2:30 Lunch (provided) 2:30 - 5:00 Hands-On TMS Small Groups

Objective: Practice the hands on skills that were introduced on day 2. Demonstrate hands on progress of competence. If students show adequate progress, they can ask to have the clinical test during this time.

5:00 Adjourn

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Thursday March 27, 2014 8:00 - 8:30 Continental breakfast

Objective: To orient attendees to the general outline of the course, where the rooms are, where support staff are, how to connect to Wi-Fi, and answer any questions they might have about the logistics of the course.

8:30 - 10:15 Overview and update on VNS, DBS and other Brain Stimulation Measures Mark S. George, M.D.

Objective: Review the other brain stimulation treatments and describe their current clinical uses to improve patient care.

10:15 - 10:30 Coffee break Objective: Ask informal questions of faculty

10:30 - 12:00 Advanced TMS discussions for clinical delivery Mark S. George, MD

Objective: This is a more socratic discussion than formal lecture. Present and discuss individual cases, or their plans for TMS clinical use, and receive feedback concerning the body of evidence for that indication or ideas about appropriate treatment (location, parameters, duty cycle, measurable outcomes).

12:00 - 1:00 Case study and Research design Objective: Ask more in-depth questions, to revisit particular clinical applications of TMS, or present their own ideas for using TMS in clinical or research settings and receive feedback from the faculty and other students.

1:00 - 2:30 Lunch 2:30 - 5:00 Hands-On TMS Small Groups

Objective: Practice the hands on skills that were introduced on day 3. Demonstrate hands on progress of competence. If students show adequate progress, they can ask to have the clinical test during this time.

5:00 Adjourn

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Friday March 28, 2014 8:00 - 8:30 Continental breakfast

Objective: To orient attendees to the general outline of the course, where the rooms are, where support staff are, how to connect to Wi-Fi, and answer any questions they might have about the logistics of the course.

8:30 - 10:15 Summarize - Mark S. George, M.D.

Objective: Summarize all content presented during the week, stressing the issues of safety, proper indications for use, emergency response to problems that they may encounter.

10:15 - 10:30 Coffee break Objective: Ask informal questions of faculty

10:30 - 12:00 In-depth discussion of focused areas on interest in Brain Stimulation. Mark S. George, MD

Objective: Discuss and demonstrate image guidance and TMS. Observe the use of TMS, MRI scanner and tour the facility with time for question and answers.

12:00 - 1:00 Case study and Research design Objective: Participate in in-depth questions, revisit particular clinical applications of TMS, or present their own ideas for using TMS in clinical or research settings reviewed by the faculty and other students.

1:00 - 2:30 Lunch 2:30 - 5:00 Hands-On TMS Small Groups

Objective: Practice the hands on skills that were introduced on day 1. If students show adequate progress, they can ask to have the clinical test during this time

5:00 Adjourn

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- Ipsum

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Please contact – Teresa Garner at 843-876-5142

Email address – garnertl@musc.edu OR

Minnie Dobbins at 843-792-5730 Email address – dobbinsm@musc.edu

For any questions.

Who Should Attend: This course is designed for psychiatrists and researchers who wish to enhance their knowledge of TMS and the related brain stimulation techniques.

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Payment must accompany registration Please make checks payable to MUSC 67 President Street Room 502 North, MSC861 Charleston, SC 29425-5712 The course registration fee is $2,500. Fee may be waived for full-time MUSC faculty and trainees, please inquire when registering. Full-time VA employees participation in CSP #556 have a different negotiated fee. Payment is due by one month before the course start date (February 28, 2014). a written notice of cancellation must be received 30 days prior to the start of this activity. A 10% cancellation fee will be assessed at that time; after that date, cancellation requests cannot be honored. Please charge my(circle one): Visa MasterCard AMEX Discover

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Contact Teresa Garner for details Phone: 843-876-5141

email - garnertl@musc.edu, Fax: 843-792-5702

You can also register at http://academicdepartments.musc.edu/psychiatry/research/bsl/Course/Index.html Americans with Disabilities Act - It is the policy of the Medical University of South Carolina not to discriminate against any person on the basis of disabilities. If you feel you need services or the auxiliary aids mentioned in this act in order to fully participate in this continuing medical education activity, please call Minnie Dobbins 843-792-5730 or attach a note to your registration form.

Brain Stimulation Laboratory 67 President Street

Room 502 North, MSC 861 Charleston, SC 29425 (843)876-5142

http://academicdepartments.musc.edu/psychiatry/research/bsl/Course/Index.html