Notes for Tokyo lecture given 11/27/18. This is too complex for me, much less an audience, so I simplified it. Robert D. McMullen, MD (only I have pswd to signature) THE MAIN THREE NETWORKS OF THE BRAIN ARE: SN (salience network): the network focused on here DMN (default mode network) –self-referential; it is activated during social reasoning, such as when we think about our own and/or others’ minds. signals from AI influence DMN; CEN (central executive network) – key nodes in PPC (Posterior parietal cortex); maintenance and manipulation of information and decision-making ; OTHER, SMALLER, NETWORKS: Cinguloopercular network -set-maintenance activities Ventral attention network –right lateralized ; overlaps with SN Task Positive Network (TPN): activated by mechanical, causal, logical, or mathematical reasoning—e.g., when watching videos about physics SALIENCE NETWORK (SN) etymology: Salient: from leaping in Latin, used for a military bulge; something protruding, standing out. Salience: being noticeable, standing out. Salient entities attract attention, are meaningful or behaviorally relevant—e.g., something out of the ordinary occurring; wrestling with an important question—e.g., a moral question, a decision about what job to take. (Salience detection has been most studied in visual research.) SALIENCE INCLUDES:
- low-level sensory features (e.g., stimulus color or intensity—usually an abrupt change in these)
- high-level cognitive and affective processes (e.g., emotional salience or personal relevance).
- integrating sensory input to guide attention; attend to motivationally salient stimuli
- recruit appropriate functional brain-behavior networks to modulate behavior.
- rTMS normalizes abnormalities in the SN loop. This may be why TMS occasionally puts multiple chronic disorders into complete remission in a single person—an outcome that is unimaginable even with multiple medications. I have 3 to 4 patients with such surprising outcomes, which I will soon describe to you.
- Examples of patients with multiple psychiatric diagnoses who became completely normal with TMS. One would scarcely imagine this outcome.
- Description of successful TMS treatment of bipolar depression and how to do it safely.
- Y.I.: Our OCD results with TMS using Brainsway h7 helmet: