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ACCREDITATION STATEMENT The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
CREDIT DESIGNATION STATEMENT The Johns Hopkins University School of Medicine designates this live activity for a maximum of 4.0 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
OTHER CREDIT American Academy of Nurse Practitioners American Academy of Nurse Practitioners (AANP) accepts AMA PRA Category 1 CreditTM from organizations accredited by the ACCME.
American Nurses Credentialing Center American Nurses Credentialing Center (ANCC) accepts AMA PRA Category 1 CreditTM from organizations accredited by the ACCME.
Contact Hours for Non-PhysiciansThe Johns Hopkins University has approved this activity for 4.0 contact hours for non-physicians.
Professional Counselors and Therapists This CE Program has been approved by the Maryland Board of Professional Counselors and Therapists for Category A CEUs.
Psychologists The Johns Hopkins University School of Medicine is authorized by the Maryland State Board of Examiners of Psychologists as a provider of continuing education. The Johns Hopkins University School of Medicine maintains responsibility for this program. A certificate for 4.0 CEUs will be awarded upon completion of this symposium.
Social Workers The Maryland Board of Social Work Examiners certifies that this program meets the criteria for 4.0 credit hours of Category 1 or 4.0 CEUs of continuing education for social workers and associates licensed
in Maryland. The Johns Hopkins University School of Medicine is an approved sponsor of the Maryland Board of Social Work Examiners for continuing education credits for licensed social workers in Maryland.
POLICY ON SPEAKER AND PROVIDER DISCLOSUREIt is the policy of the Johns Hopkins University School of Medicine that the speaker and provider disclose real or apparent conflicts of interest relating to the topics of this educational activity, and also disclose discussions of unlabeled/unapproved uses of drugs or devices during their presentation(s). The Johns Hopkins University School of Medicine OCME has established policies in place that will identify and resolve all conflicts of interest prior to this educational activity. Detailed disclosure will be made in the activity handout materials.
DescriptionThe field of brain stimulation in psychiatry continues to evolve as technology improves and as we learn more about brain function and how these treatment methods affect it. Brain stimulation is most often considered when other treatments fail or when medications elicit unpleasant or dangerous side effects. Electroconvulsive therapy (ECT) is the most applied and tested brain stimulation treatment and is far and away the most effective treatment for depression and a variety of other psychiatric conditions. ECT involves passing a carefully controlled electrical current through a person’s brain to trigger a seizure. Though highly effective, it is commonly associated with cognitive side-effects such as memory loss. Although it is more than seven decades old, there continues to be controversy surrounding ECT, not about its efficacy or its safety, which have been proven, but instead regarding fears that the procedure is barbaric and brain-altering, which can be attributed to a lack of knowledge about the procedure and its benefits. There have also been new developments in how ECT is delivered both to improve efficacy and
decrease cognitive side effects associated with the treatment that are important for mental health professionals to know. For example, recent studies have demonstrated that very narrow pulses, known as ultra-brief pulses, reduce cognitive side effects without negatively impacting efficacy. We are increasingly using ultra-brief pulses and they are now part of our default setting for new ECT patients.
New brain stimulating technologies have emerged in recent years which can directly and focally regulate brain function without producing the cognitive side-effects associated with ECT and which do not require anesthesia. Repetitive transcranial magnetic stimulation (rTMS) is one of these technologies that has proven effective in clinical trials. rTMS is non-invasive and relies on electromagnetic induction using an insulated coil placed over the scalp, focused on an area of the brain thought to play a role in mood regulation. rTMS is a recently FDA approved treatment for depression and is becoming increasingly available to patients as clinics are being opened. Accordingly it is important for practitioners to learn about how it works, who would benefit from it and how well it is tolerated.
Deep brain stimulation (DBS) is an emerging treatment option showing promise in clinical trials for mood and cognitive disorders such as Major Depression and Alzheimer’s Disease. However, it is not currently FDA approved for these conditions like it is for Parkinson’s Disease and chronic and severe Obsessive-Compulsive Disorder, which is the first DBS
psychiatric indication to receive FDA approval. Electrodes are implanted in specific regions targeting the underlying pathophysiology of the disease. Several target sites for stimulation have been proposed for the treatment of refractory depression including Brodmann area 25. PET imaging studies on depressed patients have shown DBS can reverse pretreatment blood flow changes much like antidepressant medication.
This conference will update mental health care professionals on advances in ECT, rTMS and DBS.
Who Should AttendThis activity is intended for physicians, family practitioners with a focus on mental health care, psychologists, psychiatric nurses and social workers.
ObjectivesAfter attending this activity, the participant will demonstrate the ability to:• Discuss the latest research pertaining to
improving ECT and rTMS efficacy as well as ongoing and planned DBS studies
• Recognize which types of patients might be suitable for ECT, rTMS or DBS treatment
• Recognize side-effects associated with ECT, rTMS and DBS
• Identify techniques to decrease cognitive side-effects associated with ECT
• Describe putative mechanisms by which ECT, rTMS and DBS might work.
Brain Stimulation Update:
ECT, TMS and BEYONDDepartment of Psychiatry and Behavioral Sciences
Presents
Brain Stimulation Update:
ECT, TMS and BEYONDSaturday, March 24, 2012
Johns Hopkins UniversitySchool of Medicine
Thomas B. Turner AuditoriumBaltimore, Maryland
This activity has been approved for AMA PRA Category 1 CreditsTM.Br
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General InformationREGISTRATIONSaturday, March 24, 2012 • 7:30 - 8:30 a.m.
LOCATIONThomas B. Turner BuildingThe Johns Hopkins University School of Medicine720 Rutland AvenueBaltimore, Maryland 21205
The Turner Building is located on Rutland Avenue at Monument Street. Directions and campus parking information are available on our website under the contact and travel section at www.HopkinsCME.edu. Handicapped parking is available in the nearby Rutland Garage. Johns Hopkins is smoke-free.
For Saturday activities only: Complimentary parking is available in the Washington Street Garage.
FEESREGISTRATION CUT-OFF DATE: March 18, 2012
Methods of Payment: Payment by check or credit card must accompany the registration form prior to the activity. On-site payments by credit card only. Foreign payments must be by credit card or with a U.S. Dollar World Money Order. The registration fee includes instructional materials, continental breakfast and refreshment break.
Physicians . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 100Residents*/Fellows*/Allied Health Professionals . . . . . . . . . . . . . . . . . . . . . $ 75*with verification of status
You will receive a confirmation by e-mail if you have provided your e-mail address. Otherwise confirmation will be sent by mail. If you have not received it by March 18, 2012, call (410) 502-9634 to confirm that you are registered. A certificate of attendance will be sent by May 8, 2012 to the e-mail address you provide on the registration form.
The Johns Hopkins University reserves the right to cancel or postpone any activity due to unforeseen circumstances. In this event, the University will refund the registration fee but is not responsible for travel expenses. Additionally, we reserve the right to change the venue to a comparable venue. Under such circumstances registrants will be notified as soon as possible.
LATE FEE AND REFUND POLICYA $50 late fee applies to registrations received after 5:00 p.m. EST on March 18, 2012. A handling fee of $50 will be deducted for cancellation. Refund requests must be received by fax or mail by March 18, 2012. No refunds will be made thereafter. Transfer of registration to another Johns Hopkins conference in lieu of cancellation is not possible.
HOTEL AND TRAVEL INFORMATION Participants are responsible for making their own travel and lodging arrangements. Many hotels in Baltimore offer a special rate for Hopkins employees, patients and guests. A list of recommended hotels is available on the CME website www.HopkinsCME.edu.
EMERGENCY CALLSOn March 24, 2012, direct emergency calls to the Hopkins registration desk, (410) 955-3673. Messages will be posted for participants.
AMERICANS WITH DISABILITIES ACTThe Johns Hopkins University School of Medicine fully complies with the legal requirements of the ADA and the rules and regulations thereof. Please notify us if you have any special needs.
EVALUATIONA form will be available to attendees to evaluate each session and each speaker’s presentation, as well as to identify future educational needs.
OUTCOMES SURVEYA survey will be sent to all physician attendees within three months post activity to assist us in determining what impact this activity had on the attendee’s practice.
TO REGISTER OR FOR FURTHER INFORMATIONRegister Online www.HopkinsCME.edu Register by Phone (credit card only) (410) 502-9634Register by Fax (866) 510-7088Confirmation/Certificates (410) 502-9634General Information (410) 955-2959E-mail the Office of CME [email protected] Department Website: http://www.hopkinsmedicine.org/psychiatry/For general information, the direct link for this CME activity web page is: http://www.hopkinscme.edu/CourseDetail.aspx/80028359.
Program 7:30 - 8:30 Registration and Continental Breakfast
8:30 - 8:45 Welcome and Conference Goals Irving Reti, MBBS
8:45 - 9:25 Brain Stimulation Treatment Modalities for the Management of Medication Resistant Patients: An Overview
Francis Mondimore, MD
9:25 - 10:05 Update on ECT Irving Reti, MBBS
10:05 - 10:25 Safety Aspects of Outpatient ECT Melinda Walker, RN
10:25 - 10:45 Refreshment Break
10:45 - 11:35 Update on TMS Irving Reti, MBBS
11:35 - 12:05 Interview of Patient Treated with Either ECT or TMS
Irving Reti, MBBS
12:05 - 12:45 Update on Deep Brain Stimulation for Mood and Cognitive Disorders
Paul Rosenberg, MD
12:45 - 12:50 Summary Remarks Irving Reti, MBBS
12:50 Adjourn: Please complete and return the Evaluation and Credit Report Forms. The Registration Desk will remain open during conference hours.
The Johns Hopkins University School of Medicine takes responsibility for the content, quality and scientific integrity of this CME activity.
This schedule is subject to change.
Registration Form Course Number 80028359
Brain Stimulation Update: ECT, TMS and BEYONDMarch 24, 2012
To Register: Online: www.HopkinsCME.eduBy fax: (866) 510-7088 By phone (credit card only): (410) 502-9634
Or mail this form to The Johns Hopkins University, Office of Continuing Medical Education, P.O. Box 64128, Baltimore, Maryland 21264-4128. Include check payable to HOPKINS/80028359, or include credit card information below.
PAYMENT MUST ACCOMPANY FORM TO CONFIRM YOUR REGISTRATION.
M I am a Johns Hopkins speaker for this activity.
Please type or print clearly:last name first name m.i.
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mailing address
city state ZIP + 4 code country
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You will receive a confirmation notice and your attendance certificate by e-mail if you provide your e-mail address. M Check here if you wish to receive e-mail and/or fax notices about upcoming
CME activities.
What do you hope to learn by attending this activity?
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Please notify us if you have any special needs.
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Registration Fees:M Physicians . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 100M Residents*/Fellows*/Allied Health Professionals. . . . . . . . . . . . . . . . . . . $ 75
*with verification of status
For registrations received after 5:00 p.m. EST on March 18, 2012, include a $50 late fee. On-site registrations are payable only by credit card.
Total amount enclosed $ ________________Payment Type:
JHU Faculty/Staff Only: If you are using your Tuition Remission Benefit or an ION budget, please complete this registration form and return with appropriate payment processing form to OCME, Turner 20.Forms can be found on-line at http://www.hopkinscme.edu/Resources/resources.aspx.
M Check (See instructions on top of form.)M Credit Card: M VISA M MASTERCARD M DISCOVER M AMEX
Card # - - - Exp. Date __________
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Activity DirectorIrving Reti, MBBS is an Associate Professor of Psychiatry and Behavioral Sciences and Neuroscience at the Johns Hopkins University School of Medicine and is the Director of The Brain Stimulation Program at The Johns Hopkins Hospital. Dr. Reti is from Australia and attended medical school at the University of Sydney before coming to Johns Hopkins for psychiatry residency. He then completed a neuroscience fellowship and joined the faculty in 2001. Dr. Reti’s clinical and research focus has been the management of mental illness, and especially depression, using brain stimulation modalities, in particular ECT and rTMS. He has administered thousands of treatment sessions using these modalities and also leads clinical trials evaluating novel forms of ECT and rTMS. Dr. Reti also directs an NIH-funded preclinical lab investigating brain pathways and molecular mechanisms underlying the therapeutic effects of ECT and rTMS. These laboratory studies will lead to new and improved ways to alleviate depression.
SpeakersFrancis Mondimore, MD is an Associate Professor of Psychiatry and Behavioral Sciences at the Johns Hopkins University School of Medicine and the Associate Clinical Director of the Department of Psychiatry and Behavioral Sciences at The Johns Hopkins Hospital. He received his medical degree from Johns Hopkins and also completed his residency in psychiatry at The Johns Hopkins Hospital. Dr. Mondimore is the author of five books for general audiences on mental health issues, which have been translated into seven languages. They include Bipolar Disorder, A Guide for Patients and Families, and, with co-author Patrick Kelly, MD, Borderline Personality Disorder, New Reasons for Hope, coming this fall from the Johns Hopkins University Press. He has also authored numerous book chapters and scientific articles and is on the faculty editorial board of the Johns Hopkins University Press. In addition to his consumer education work, Dr. Mondimore is interested in developing best practices guidelines for the treatment of mood disorders.
Paul Rosenberg, MD is Associate Professor of Psychiatry and Behavioral Sciences at the Johns Hopkins University School of Medicine. Dr. Rosenberg’s research focuses on developing biomarkers and treatments for Alzheimer’s Disease. His current projects are focused on PET imaging of neuroinflammation and amyloid deposition in Alzheimer’s Disease, CSF markers of inflammation in delirium, neuropsychiatric symptoms as risk factors for developing mild cognitive impairment and Alzheimer’s Disease, treatment of neuropsychiatric symptoms of Alzheimer’s Disease, and development of novel anti-amyloid and anti-inflammatory treatments for Alzheimer’s Disease. Dr. Rosenberg is a recipient of a K08 training grant from NIA and AFAR “PET imaging of microglial activation in Alzheimer’s Disease” and a 2008 Paul Beeson Scholar. He currently directs several trials of novel treatments for Alzheimer’s Disease and has been the recipient of three NIH-funded R01 grants supporting these projects.
Melinda Walker, RN is a Registered Nurse with over 15 years experience in psychiatry at The Johns Hopkins Hospital. She is certified and experienced in the nursing specialty of post anesthesia care nursing as well as psychiatric nursing. The dedicated ECT post anesthesia nursing team, along with an anesthesia provider, delivers constant care to patients recovering from the anesthesia and electroconvulsive treatment. In addition, Ms. Walker offers education to patients and their families throughout their course of treatment.
