Mental Health in the News: July 28, 2022

By Dr. David Woo - July 28, 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.

Researchers Use MRI to Observe Effects of Transcranial Magnetic Stimulation on Depressed Patients

According to the World Health Organization, 3.8% of people worldwide suffer from depression. Transcranial magnetic stimulation (TMS) is proven to treat depression symptoms and reduce suicidal ideation. During TMS treatment, an electromagnetic coil is placed on the scalp. The coil safely emits magnetic pulses into the brain–the TMS coil is usually aimed at the right or left side of the dorsolateral prefrontal cortex (DLPFC), the region of the brain responsible for regulating emotional responses. 

While scientists know that TMS electrically stimulates brain cells to strengthen communication pathways between different regions of the brain, the manner in which it occurs is still unknown. To answer this question, in 2022, a team of Canadian and American researchers recently used magnetic resonance imaging (MRI) scans to see, in real-time, changes that occur in the brains of depressed patients during TMS treatment. The aim of the study was to observe changes in brain activity that had been previously recorded in an earlier study, in which researchers were able to see, using an MRI machine, how TMS produced lasting improvements in connectivity between the DLPFC and the amygdala, a region of the brain responsible for emotional processing and response, including love, fear, and anger. Researchers in 2022 hoped to observe similar changes in brain activity in clinically depressed patients and to look for a correlation between changes in brain activity and changes in depressive symptoms. 

For this study, researchers recruited study participants who were diagnosed with major depression that was also treatment-resistant, meaning that the patients did not find relief from depression symptoms with antidepressants. All study participants underwent daily TMS therapy for 4 weeks. 

MRI scans from before, during, and after treatment were compared to reveal observable, yet short-lived, changes in brain activity, including improvements in functional connectivity between brain hemispheres. Patients, on average, showed a drop of 10.87 points in scores on the Montgomery-Asberg Depression rating scale, a standardized questionnaire given by a psychiatrist to measure the severity of a patient’s depression symptoms. A drop in points indicates an improvement in depression symptoms. 

While further research is needed, the results of the study suggest that long-term TMS treatment may yield longer-lasting results.

To read the original news article, click here. 

Observing School and Hospital Data to Predict Risk of Self-Harm in Adolescents

About 1 in 5 adolescents in England self-harm and emergency departments receive about 12% of self-harm episodes. To better understand a person’s risk factors for self-harm, researchers at King’s College London and South London and Maudsley NHS Foundation Trust analyzed data from 2009-2013 for more than 111,000 children and adolescents between the ages of 11 and 17. Autism, ADHD, and school absence were found to be the greatest indicators of self-harm.

The analysis showed that boys with autism spectrum disorder (ASD) were found to be almost three times more at risk of self-harm than boys without ASD. While girls with ASD were not at a greater risk of self-harm compared to girls without ASD, in general, girls with ASD were seen to have a greater risk than boys with ASD. 

Both boys and girls with attention deficit hyperactivity disorder (ADHD) were found to be four times more at risk than those without ADHD. 

Researchers observed that students with less than 80% school attendance were three times more likely to self-harm. Children with lower school attendance, due to exclusion or absence, are at greater risk of self-harm. Combining educational and mental health data may aid in improving support in schools where needed.

Further, the study found that non-native, English-speaking students were found to be at less risk of self-harm than native English speakers. This data suggests that non-native students tend to go unreported when they self-harm, or that they act out in other ways, such as substance abuse.

To complete this study, researchers received funding from the National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre and the Wellcome Trust. It is the first study to use hospital and school data to investigate the relationship between self-harm and ASD.

To read the original news article, click here. 

New Method of TMS Improves Depression Symptoms and Lowers Treatment Duration

A study published in the Journal of Affective Disorders reported that a customized version of transcranial magnetic stimulation (TMS), guided by quantitative EEG (qEEG) analysis, showed a reduction of half of the depression symptoms in 47% of patients treated with the device.

One out of three patients achieves remission with repetitive TMS, according to previous research. The present study aimed to improve response rates and treatment duration. Researchers used a method of qEEG to produce an EEG make-up correlated with depression or anxiety. To reduce treatment time, researchers used a theta-burst stimulation (TBS) delivery method.

Quantitative EEG analysis was used to determine where TMS magnetic pulses should be administered, as well as the strength of these pulses. 

Researchers assessed study participants’ depression symptoms before TMS treatment using the Hamilton Depression Rating (HDR) scale, the most commonly used depression assessment tool administered by clinicians. Patients were evaluated once more, four weeks after treatment.

Over an average of approximately 7 sessions, 47% of patients showed a reduction in HDR depression scores of 50% or more. An additional 29% of participants showed a 30 to 50% reduction in HDR depression scores. Theta burst stimulation nearly shortened the treatment session time in half.

To read the original news article, click here. 

Dr. David Woo

Dr. Woo has been seeing patients in private practice since 2002, always with the goals of combining evidence-based medicine with psychodynamic psychotherapy and collaborating with other mental health professionals to ensure the best possible outcomes for his patients. He has been certified to administer TMS at his practice since 2017. His greatest clinical interests include helping patients suffering from depression, anxiety, and obsessive compulsive disorder.