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UAB’s New Magnetic Therapy for Depression Succeeds Options
Posted: Thursday, February 3, 2011 9:00:23 AM
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University of Alabama at Birmingham (UAB) is the first medical provider in the state to offer a new, cutting-edge treatment for depression.

Repetitive transcranial magnetic stimulation, or rTMS, is the first and only device of its kind to be cleared for the treatment of depression by the U.S. Food and Drug Administration.

The noninvasive device delivers highly focused, MRI-strength magnetic pulses to a particular area of the brain that is linked to depression. It is indicated for patients with depression who have failed to achieve satisfactory improvement from prior antidepressant medication.

“rTMS uses a series of strong, focused magnetic pulses to stimulate a part of the brain called the left dorsolateral prefrontal cortex,” says Bates Redwine, M.D., assistant professor in the UAB Department of Psychiatry and Behavioral Neurobiology. “This part of the brain is known to have decreased activity in depressed patients.

“The magnetic pulses pass through the scalp and skull to the brain, where they cause these brain cells to activate,” he says. “Repeated stimulation over a series of weeks causes sustained activation of this specific area of the brain that results in significant improvements in depressive symptoms.”

Dr. Redwine says the procedure takes about 40 minutes. Patients come five days a week for therapy, and results usually are evident within four to six weeks. The device consists of a chair with the magnetic stimulator attached to a flexible arm.

“Patients sit in the chair with the magnet positioned in the appropriate spot, where it delivers the focused magnetic pulse,” Dr. Redwine says. “Patients will hear a clicking sound while the device is pulsing, but there are no significant side effects. Most patients watch TV or even nap during the procedure.”

Dr. Redwine says clinical trials of the rTMS system, which is produced by NeuroStar, show that more than half of the patients treated had significant improvement in symptoms of depression and a third had complete remission of all symptoms.

“We know that more than 30% of patients with depression do not benefit from and/or are intolerant of antidepressant medications,” Dr. Redwine says. “It’s gratifying to have a new tool that we can offer to patients that has demonstrated an impressive success rate.”

The therapy is not covered by many health insurance plans, although there is movement underway with the insurance industry to provide coverage. Dr. Redwine says that in the long run, use of the rTMS system may prove to be more economical than current approaches to treating depression.

For more information about rTMS therapy at UAB, call (205) 996-7431.

MD News January/February 2011, Birmingham
Posted: Thursday, February 3, 2011 9:25:58 AM
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If the pulses can be focused with such precision it conjurs up visions of Pavlovian addicts stimulating their pleasure centres. You could use it in prisons to pacify violent inmates (probably cheaper than heroin). More positively, depression can be a severely debilitating condition and hugely expensive in terms of treatment and lost working hours. New technology; New pros and cons.
Posted: Thursday, February 3, 2011 10:24:13 AM

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This is great news, Christine. I am a depressive who takes 4 antidepressants to feel normal. Thank God for those antidepressants. I feel so sorry for those who do not get relief from meds. Now it looks like they can. Depression is a debilitating disease that those who do not have it can't understand. Why is this in English Grammar?
Posted: Thursday, February 3, 2011 10:40:38 AM

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Nova Science Now broadcast a program on the brain last night (2/2/2011) which included a segment on TMS (Transcranial Magnetic Stimulation).

Nova Science Now: How Does the Brain Work? Click on the picture to start the program.

Continuing through today (3 February) only, you can ask questions of the man who presented the research on TMS, Dr. Mark George.

Nova Science Now: online Q&A

Posted: Thursday, February 3, 2011 2:09:36 PM
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WOW, Ruth, that was great! Thanks. I think I have a form of synesthesia. I hear someone walking behind me and I feel a tap on my shoulder. It feels so real it must have happened, right? Wrong! I look behind me and the person is too far away to touch me, or they swear they did not tap my shoulder. Another sensation error happens when I'm sitting in a chair and I swear a light weight furry animal jumps up behind my back. I have no furry animals so why did I feel it? There's evidently an abnormal connection in my somatosensory pathway that connects what I hear, or need (comfort) to the sensation neuropathway of what I feel.

bonyfriend, I certainly hope you get relief soon. There's help on the horizon, I can feel it... creeping up my back, hee hee.

Christine, thank you for starting this wonderful thread. Neuroscience is right up my alley. When I watched Ruth's Nova video, I couldn't help thinking how TMS might change a juror's moral compass if jail space is too tight.
Judge: There's no jail space for the defendant, attach the TMS to all 12 jurors please.

The 12 jurors find the defendant 'not guilty' and he is released.

Sorry, but I usually play devils advocate whenever something new in science pops up.

Posted: Friday, February 4, 2011 7:34:43 AM
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Article in Journal of Neuroscience is a bit more wary.

"Brain Stimulation In Depth
Peter Stern
Transcranial magnetic stimulation (TMS) is a noninvasive clinical method of stimulating the human brain, which has been tested for the treatment of depression and other neurological disorders. Depending on the stimulation protocol used, TMS can increase or decrease cortical excitability; however, how it does so is poorly understood. Benali et al. thus used electrophysiological recording techniques and immuno-histochemistry to analyze the changes that occur in the rat brain after different repetitive TMS protocols. They found that two theta-burst stimulation (TBS) protocols that in the past have been shown to modify human cortical excitability in opposite ways also affected rat cortical activity and protein expression. Although both intermittent and continuous TBS affected cortical inhibitory neuronal systems, the cell types affected, and thus the overall effects of the stimulation, differed. These findings sound a note of caution because such impairment of the cortical inhibitory system may also take place in the human cortex. They also raise the critical question of whether these novel and increasingly popular high-frequency TMS protocols are really safe for use in human cognitive or clinical neuroscience.
J. Neurosci. 31, 1193 (2011). "
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