Psychiatry and Behavioral Sciences
Mark S. George, MD
Mark S. George, MD
As an undergraduate student in philosophy at Davidson College in Davidson, NC, Dr. George first began studying the relationship between mind and brain, or brain/behavior relationships. He has continued this interest throughout his career with a focus on using brain imaging and brain stimulation to understand depression and devise new treatments.
He received his medical degree from the Medical University of South Carolina in Charleston in 1985, where he continued with dual residencies in both neurology and psychiatry. He is board certified in both areas. Following his residency training he worked for one year (1990-91) as a Visiting Research Fellow in the Raymond Way Neuropsychiatry Research Group at the Institute of Neurology, Queen Square, London, England. During his fellowship he wrote one of the first textbooks in the new area of brain activation and imaging.
He then moved to Washington, DC, working with Dr. Robert Post in the Biological Psychiatry Branch of the Intramural National Institute of Mental Health (NIMH). During his 4 years at NIMH he was one of the first to use functional imaging (particularly oxygen PET) and discovered that specific brain regions change activity during normal emotions. He then started using imaging to understand brain changes that occur in depression and mania, a quest that he and many others are still pursuing. This imaging work directly led to his pioneering use of a non-invasive brain stimulation method, transcranial magnetic stimulation (TMS), as a probe of neuronal circuits regulating mood, and to clinical trials using TMS as an antidepressant. In 1993 while at the NIMH, he discovered that daily prefrontal rTMS over several weeks could treat depression and ever since he has worked to grow the science of TMS, both in terms of how it works in the brain, and in critically evaluating its therapeutic applications, especially in the area of treating depression. This was FDA approved in October, 2008. He has completed the pivotal study in this area with NIH funding and is now investigating its effectiveness in the VA population through a VA cooperative study.
In 1995 he moved back to Charleston and built the functional neuroimaging division and brain stimulation laboratories. This imaging group has grown into the MUSC Center for Advanced Imaging Research, which is now part of the SC Brain Imaging Center of Excellence. He continues to use imaging (particularly functional MRI) and non-invasive stimulation (TMS, or VNS), either separately or more recently in combination, to understand the brain regions involved in regulating emotion in health and disease. In June 1998 at MUSC, he also pioneered another new treatment for resistant depression, vagus nerve stimulation (VNS). This was FDA approved in 2006. He and his group have used MRI imaging to understand VNS brain effects.
He is a world expert in brain stimulation, and depression, and is the editor-in-chief of a new journal he launched with Elsevier in 2008 called, Brain Stimulation: Basic, Translation and Clinical Research in Neuromodulation. He has been continuously funded by NIH and other funding agencies since his fellowships. He has received both a NARSAD Young Investigator and Independent Investigator Award to pursue TMS research in depression. He has received numerous international awards including the NARSAD Klerman Award (2000), NARSAD Falcone Award (2008) and the Lifetime Achievement Award (2007) given by the World Federation of Societies of Biological Psychiatry (WFSBP). In 2009 US News and World Report named him one of 14 ‘medical pioneers who are not holding back’. He is on several editorial review boards and NIH study sections, has published over 300 scientific articles or book chapters, has 8 patents, and has written or edited 6 books.
|At the completion of this session, the participant will be able to:|
|1. Discuss the recent clinical data regarding the acute antidepressant effects of TMS, and the meager maintenance data.|
2. Describe different theories about how prefrontal TMS is working to treat depression, including to concept of prefrontal
cortical control, and the idea of the concept of control and learned helplessness.