Heather Burrell Ward, MD
@heatherwardmd.bsky.social
140 followers 230 following 33 posts
Psychiatrist. Director of Neuromodulation Research & Assistant Professor @VUMCPsych using fMRI/TMS to study the brain circuit basis of co-occurring substance use and psychotic disorders. Mom. www.vumc.org/heatherwardlab/
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Reposted by Heather Burrell Ward, MD
npp-journal.bsky.social
This recent Research Highlight from @heatherwardmd.bsky.social‬ discusses how single rTMS sessions with fMRI to probe mechanism are critical stepping stones that line the path toward highly effective neuromodulation interventions for substance use

www.nature.com/artic...
One step at a time: use of single-session rTMS to test novel targets for substance use disorders
Neuropsychopharmacology - One step at a time: use of single-session rTMS to test novel targets for substance use disorders
www.nature.com
heatherwardmd.bsky.social
8. These results have dramatic implications for treatment of psychomotor function in psychotic disorders, as they suggest a unifying role of DMN connectivity in psychomotor disturbance 🏃, overall function, and well-being 😀.
heatherwardmd.bsky.social
7. We identified significant relationships between the same brain regions and their connectivity patterns to the DMN that were related to well-being 😀, overall function, and grip strength 💪.
heatherwardmd.bsky.social
6. Higher grip strength 💪 was correlated with greater connectivity from multiple brain regions to the DMN. Given associations between grip strength and well-being, we repeated this analysis to see if we would identify similar brain correlates for grip and well-being – and we did.
heatherwardmd.bsky.social
5. Using data from the multi-site Human Connectome Project for Early Psychosis (HCP-EP, n=206), we performed a multivariate pattern analysis of the entire connectome 🧠 to identify brain circuits linked to grip strength 💪, overall function, and well-being 😀.
heatherwardmd.bsky.social
4. The brain 🧠 correlates of grip strength have been presumed to lie in the motor system, so previous brain analyses are frequently restricted to motor regions. However, a unifying brain circuit explanation linking grip strength and overall well-being has remained elusive 👀 until now
heatherwardmd.bsky.social
3. Grip strength 🏋️ is one measure of motor function associated with all-cause mortality and overall well-being. It has been assumed that associations between grip strength and well-being are purely related to mechanical impairments reflective of overall poorer physical health.
heatherwardmd.bsky.social
2. Psychomotor disturbance is highly prevalent across psychiatric disorders and has many manifestations, e.g., catatonia, psychomotor retardation, psychomotor agitation, etc. But what is the neurobiological mechanism of psychomotor disturbance 🏃 in psychiatric disorders?
heatherwardmd.bsky.social
7. TMS is an exciting intervention for SUDs because of the flexibility in its administration schedule. We should design and test alternative TMS dosing schedules that are: 1) Highly effective 💪 and 2) Accessible for individuals recovering from SUDs.
heatherwardmd.bsky.social
6. Extended dosing: Recovery from substance use takes time and behavior change, and symptoms of post-acute withdrawal can persist for weeks. Extended TMS dosing, such as multiple sessions/day once per week, may be an opportunity to provide continued treatment & relapse prevention
heatherwardmd.bsky.social
5. Accelerated dosing: Newer, accelerated protocols apply multiple TMS sessions per day to shorten time to response. However, protocols that involve treatment for 10h/day x 5 days pose challenges to recovery goals, such as full-time employment, education, or caretaking.
heatherwardmd.bsky.social
4. Flexible dosing: Traditional TMS protocols involve weekly treatment for weeks at a time. Recently, studies have tested flexible protocols that provide TMS a few times/week, allowing for more scheduling flexibility (Meredith Addicott & Greg Sahlem)
heatherwardmd.bsky.social
3. As TMS has been increasingly studied as a novel intervention for SUDs, the principle of patient-centered care has been absent from protocol design. We focus on dosing schedule and advocate for patient-centered neuromodulation protocols to support recovery from SUDs.
heatherwardmd.bsky.social
2. TMS has growing interest and evidence as a novel treatment for substance use disorders (SUDs). Substance use treatment has embraced patient-centered care approaches that prioritize a patient’s individual needs, goals, and treatment preferences.
heatherwardmd.bsky.social
1. Excited to share “Rewiring recovery: Patient-centered 🧲🧠 neuromodulation interventions for substance use disorders that meet people where they are,” in Transcranial Magnetic Stimulation with @VUMCPsych collaborators Sophia Blyth and Kristopher Kast www.sciencedirect.com/science/arti...
Reposted by Heather Burrell Ward, MD
heatherwardmd.bsky.social
These labor-intensive, mechanistic TMS studies are 🏋️‍♀️ challenging to conduct but provide critical stepping stones for future TMS clinical trials.
heatherwardmd.bsky.social
Only if it’s a randomized, crossover, within-subjects design 🤣
Reposted by Heather Burrell Ward, MD
esolomon.bsky.social
Excited to announce award of my K99/R00 "Theta burst modulation of hippocampal-cortical rhythms in schizophrenia," under amazing mentors at Stanford including @coreykeller.bsky.social! We will ask whether hippocampal oscillations can be systematically influenced by stimulation in schizophrenia.
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