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By Dr. David Woo - August 25, 2022
Welcome to Madison Avenue TMS & Psychiatry’s Mental health in the News weekly update. Below are some current news events relating to mental health and mental health treatments.
An Alternative Treatment for Mental Disorders: Transcranial Magnetic Stimulation (TMS)
In the United States alone, 20 million people suffer from depression. Traditional treatments for depression include psychotherapy and antidepressant medication. However, studies show that more than five million depression patients have what’s called treatment-resistant depression (TRD)–meaning that these patients do not find relief from first-line methods, such as antidepressants and therapy. Patients with TRD are often left without the help and answers they need, pushing researchers to seek out new and alternative treatments.
In 2008, the FDA approved transcranial magnetic stimulation (TMS) as a treatment for depression. TMS is a medication-free, noninvasive treatment that uses magnetic fields to stimulate the brain. In this procedure, a coil is placed on the patient’s head, the coil then delivers magnetic pulses that target the area of the brain that regulates mood.
TMS was first developed by Dr. Anthony Barker in 1985. His research demonstrated that magnetic fields applied to the motor cortex in the brain could produce twitching in a patient’s hand without causing pain or major discomfort. Modern innovations have built on his work and the magnetic pulses of new TMS technology can penetrate the brain more deeply and more precisely than before, allowing technicians to target different areas of the brain and thereby treat a number of different addictions and mental health disorders.
When compared to other traditional treatments, TMS offers several benefits. Antidepressants often come with difficult side effects, like a change in appetite, sexual dysfunction, insomnia, or significant weight gain. Medications are considered systemic, since they enter the bloodstream and cause body-wide effects.
Additionally, about 40% of patients simply do not respond to medication, leaving a gap in treatment. TMS is medication-free and the most common side effects, headache and scalp discomfort, are mild and well-tolerated. TMS can be a standalone treatment or used alongside other therapies, even with certain antidepressants.
The future of using TMS to treat mental health disorders is promising. As technologies improve and more research proves the effectiveness of TMS, the hope is for more patients to experience the benefits TMS can have for their mental health.
To read the original news article, click here.
Using Deep Transcranial Magnetic Stimulation (dTMS) to Fight Alcohol Addiction
Alcohol addiction affects millions of people and accounts for 6% of deaths globally. Despite the negative effects of alcohol abuse, only 25% of people suffering from an alcohol addiction receive treatment. This is due in part to the lack of effective treatment options currently available. In a recent study, researchers found that deep, repetitive transcranial magnetic stimulation (dTMS) may help treat alcohol addiction. Approved by the FDA, TMS is a non-invasive treatment that uses magnetic fields to stimulate the brain.
In this double-blind study, 51 participants randomly received either active or sham (placebo) TMS treatments. Neither the participants nor the technicians knew who was receiving which treatment. For three weeks, patients received five 30-minute sessions per week. Before treatments, participants held and smelled (but did not ingest) alcohol to induce cravings. During the treatments, technicians targeted the prefrontal cortex (PFC) and anterior cingulate cortex (ACC), areas of the brain associated with cravings, decision making, and drug-seeking behaviors.
While some participants had to drop out of the study due to relapse, researchers saw a dramatic decrease in the percentage of heavy drinking days (pHDD) in those that completed the program. Dr. Heilig, one of the researchers, acknowledges that a reduction in pHDD is to be expected in alcohol studies since people seeking help naturally reduce their consumption when they start treatment. However, this experiment was different. Those who received active TMS not only showed a greater decrease in consumption during treatment but also continued to drink less during the 12-week follow-up phase. Conversely, those who received sham treatments showed a much smaller reduction in consumption during treatment, and pHDD actually increased in the weeks following treatment.
As a proof-of-concept study, this research is still in the early phases; however, there are plans for a future phase-3 study. With so many patients in need of safe and effective treatments, physicians are excited about the promising results of TMS to help treat addictions.
To read the original news article, click here.
New Research Links a Brain Circuit to Treating Addiction
Researchers from Brigham and Women’s Hospital discovered that a specific brain circuit might be the key to treating substance abuse disorders.
Substance abuse is a public health crisis, often resulting in hospitalizations and death. Currently, there is a lack of effective and long-lasting treatment options, and a need for new treatments, such as neuromodulation therapies like transcranial magnetic stimulation (TMS), which alter nerve activity in the brain using stimulation. In order to increase the effectiveness of neuromodulation treatments, it is critical that technicians know which parts of the brain to target. A new study suggests that, instead of targeting general brain regions, technicians should focus on a specific brain circuit linked to addiction remission.
This discovery came about when researchers analyzed patients who had stopped smoking after having a brain lesion, usually from a stroke. In this study, researchers used a new technique, called lesion network mapping, to compare the lesions of nicotine quitters and non-quitters. What they found was that smoking remission traced back to a specific brain circuit, not just a general brain region. Next, they examined brain lesions in patients with alcoholism and found that alcohol remission also traced back to a similar brain circuit, providing a potential map of a specific neural pathway that could treat general addiction, not just addiction to specific substances.
The next step is to test these targets using neuromodulation therapies, like TMS, in clinical trials to see if, in fact, they result in long-lasting relief of symptoms. While there is still more research to do, the authors of the study are hopeful that their findings will lead to more effective treatments for substance abuse patients.
To read the original news article, click here.
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