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The notion of applying an electrical current to the brain to modulate neural activity and treat patients has existed since the eighteenth century. Brain stimulation interventions, specifically electroconvulsive therapy (ECT), preceded the discovery of psychiatric medications and remain one of the most effective psychiatric treatments. Despite the tremendous benefit, for decades ECT remained the only brain stimulation treatment in psychiatry, and there remains little understanding of the mechanism underlying its treatment effects. However, in the past 20 years, brain stimulation therapies have undergone a revolution with the development of a number of novel brain stimulation interventions (Table 30–1). Many of these new therapies have emerged from progress in neuroimaging and brain stimulation technology, and some are entering routine clinical use. Brain stimulation interventions represent a novel and expanding approach to understanding and treating psychiatric disorders.
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