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Magnetic Brain Stimulation for Depression

by Rob343088

Transcranial Magnetic Stimulation has increasingly been used as a
treatment for mental illnesses like major depression.  High
frequency rTMS targeted to the left dorsolateral prefrontal
cortex has mood elevating effects on patients.  When this high
frequency is used, the brain area being stimulated actually
becomes more active.  People with depression often have
underactivity in this area of the brain and this leads to
feelings of apathy and lethargy.  Recently a new meta-analysis of
studies has come out indicating that this treatment does in fact
work better than sham treatment.

The researchers looked at thirty double-blind sham-controlled
parallel studies that had a total of 1164 patients and found that
the real treatment was clinically significantly more effective
than sham treatment.  The effect on mood was similar in size to
commercially available antidepressants.

Researchers have actually had quite a bit of difficulty in
distinguishing real rTMS from placebo or sham rTMS for several
different trials.  Depression is a multifaceted disorder.  It has
many different symptoms and simulation of the left dorsolateral
prefrontal cortex might only be expected to improve specific
symtpoms.  Many other symptoms might not improve when stimulating
that area.  The benefits to rTMS is that stimulating the left
dorsolateral prefrontal cortex with transcranial magnetic
stimulation is relatively selective and has few if any side
effects.  Stimulating that area of the brain could be expected to
improve apathy, anergia, indifference, poor concentration and
also psychomotor retardation(slowed speaking).

Researchers have also found that if they use low frequency
stimulation targeted to another area of the brain (the right
dorsolateral prefrontal cortex) they can also improve a person's
mood.  In this area they use TMS to reduce overactivity as
opposed to increasing it.  Recently researchers have found a way
to get even more of a response from the low frequency TMS by
doing something called "priming".  This is basically using a
higher frequency to stimulate the target area and then following
it by stimulation with a lower frequency.  Low frequency
stimulation has the benefit of not causing a seizure unlike high
frequency.  So researchers may be more likely to decrease brain
activity with low frequency rTMS.

I think in the future doctors will be able to look at a brain
scan to tell which areas are overactive or underactive in
comparison to a real brain.  Then they will be able to use TMS to
selectively increase or decrease activity in specific brain
regions.  This will allow a very targeted treatment for many
brain based disorders.  A person can have their treatment very
targeted to improve their specific symptoms.

See my blog <A
HREF="http://brainstimulant.blogspot.com/2008/05/transcranial-magnetic-stimulation-and.html">transcranial
magnetic stimulation depression</a> and <A
HREF="http://brainstimulant.blogspot.com/2008/05/transcranial-magnetic-stimulation-and.html">TMS
depression</a>  and finally <A
HREF="http://brainstimulant.blogspot.com/2008/05/transcranial-magnetic-stimulation-and.html">rTMS
depression</a> for more information.

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