Eleanor Cole, Ph.D., demonstrates treatment for study participant Deirdre Lehman in May 2019 at the Stanford Brain Stimulation Lab.Steve Fisch for Stanford Medicine Hide caption
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Eleanor Cole, Ph.D., demonstrates treatment for study participant Deirdre Lehman in May 2019 at the Stanford Brain Stimulation Lab.
Steve Fisch for Stanford Medicine
After 40 years battling a crippling depression, Emma found herself on the brink.
"I was suicidal," said Emma, a 59-year-old Bay Area resident. Because of the stigma attached to mental illness, NPR does not use her full name upon her request. "I almost died."
Over the years, Emma has spent hours in talk therapy and experimented with different antidepressants "to give herself some semblance of normalcy." And yet she was consumed by unrelenting fatigue, insomnia, and chronic nausea.
Depression is thatthe leading cause of disability worldwide, in part because treatment options often result in multiple side effects or are unresponsive to patients. And there are many people who never seek treatment because mental illness can be ongoingstrong stigma and discrimination. studies showUntreated depression can lead to suicide.
Three years ago, Emma's psychiatrist insisted that she enroll with oneto studyat Stanford University School of Medicine, developed for people who have run out of options. On their first day, the scientists performed an MRI scan to determine the best possible location for delivering electrical impulses to the brain. Then Emma sat in a chair for a 10-minute block every hour, 10 hours a day, for five straight days while a magnetic field stimulated her brain.
At the end of the first day, an unusual calm had come over Emma. Even when her partner picked her up at home, she remained relaxed. "I'm usually hysterical," she said. "I'm reaching for things all the time. I scream, you know, 'Have you seen those lights?' And when I drove home that first night, I just looked out the window and enjoyed the drive."
The cure was a new type of repetitive transcranial magnetic stimulation (rTMS) called "Stanford Neuromodulation Therapy". By adding imaging technology to the treatment and increasing the rTMS dose, scientists have developed an approach that is more effective and works more than eight times faster than the currently approved treatment.
A coil placed on Emma's head created a magnetic field that sent electrical impulses through her skull to tickle the surface of her brain. She says it felt like a woodpecker tapped her skull every 15 seconds. The electrical current is sent to the prefrontal cortex, the part of the brain that plans, dreams, and controls our emotions.
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"It's an area that's considered underactive in depression," said Nolan Williams, a psychiatrist and rTMS researcher at Stanford. "We're sending a signal so the system doesn't just turn on, it stays on and remembers to stay on."
Williams says pumping up the prefrontal cortex helps deactivate other areas of the brain that trigger fear and anxiety. This is the basic premise of rTMS: Electrical impulses are used to compensate for irregular brain activity. As a result, people feel less depressed and have more control. All of this applies to the new treatment – it just works faster.
This is shown by a randomized control study recently published in the American Journal of PsychiatryStunning results are possible in five days of treatment or less. Almost 80% of the patients went into remission - that is, they were symptom-free within a month. This compares to around 13% of people who received the placebo treatment.
For the control group, the researchers camouflaged the treatment with a magnetic coil that mimicked the real treatment. Neither the scientist who performed the procedure nor the patients knew whether they were receiving the real or the fake treatment. Patients reported no serious side effects. The most common complaint was a mild headache.
Stanford's new delivery system could even outperform electroconvulsive therapy, which is the most popular form of brain stimulation for depression, but while faster, it requires general anesthesia.
"Not only did this study show some of the best remission rates we've seen in depression," he said.Shan Siddiqi,a Harvard psychiatrist unrelated to the study, "but was also able to do this in people who had already failed several other treatments."
Siddiqi also said the study's small sample size, which includes just 29 patients, is not a cause for concern.
"Often a clinical trial [according to predetermined criteria] is terminated early because the treatment is so effective that it would be unethical to continue giving people a placebo," Siddiqi said. "That's what happened here. They originally planned to recruit a much larger sample, but the interim analysis was final."
Nolan Williams demonstrates the magnetic brain stimulation therapy he and colleagues developed on Deirdre Lehman, a participant in an earlier study of the treatment.Steve Fisch for Stanford Medicine Hide caption
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Steve Fisch for Stanford Medicine
Nolan Williams demonstrates the magnetic brain stimulation therapy he and colleagues developed on Deirdre Lehman, a participant in an earlier study of the treatment.
Steve Fisch for Stanford Medicine
Mark George, a psychiatrist and neurologist at the Medical University of South Carolina, agrees. He points to other studies of a similar size on the treatment of depression, such asKetamine, a version of which is now FDA approved.
He says the new rTMS approach could be a game changer as it is more accurate and works faster than previous versions. George pioneered an rTMS treatment that was approved by the Food and Drug Administration for depression in 2008. Studies show that it producesan almost complete loss of symptoms in about a third of patients; another third feel slightly better and another third do not react at all. However, the main problem with the original treatment is that it lasts six weeks, which is a long time for a patient in crisis.
"This study shows that you can speed everything up and add treatments on a given day and it works," George said.
The shorter treatment will improve access for many people who cannot take six weeks off work or cover childcare for that long.
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"The most exciting applications, however, are because of speed," said George. “These people [the patients] were no longer suicidal and depressed within a week. These patients are just cluttering up our emergency rooms, our psychiatric hospitals. And we really don't have good treatments for acute suicidality.”
After 45 years of depression and multiple failed attempts to treat his illness, civil engineer Tommy Van Brocklin says he saw no way out.
"In the last two years, I've started crying a lot," he said. "I was just a real emotional wreck."
For example, last September, Van Brocklin flew across the country from his home in Tennessee to Stanford, where he underwent the new rTMS treatment for a single five-day treatment. Almost immediately, he began to feel more optimistic and to sleep deeper and deeper.
"I'm waking up now and I want to go to work, whereas before I'd rather poke myself in the eye with a sharp stick," said Van Brocklin. "Since my treatment, I haven't had a single day with depression."
He's confident the changes will last. More larger studies are needed to see how long the new rTMS treatment lasts.
At least for Emma, the woman who received the Stanford treatment in a similar study three years ago, the results hold up. She says she still has ups and downs, but "it's completely different for me to deal with."
She says the regime reprogrammed her from within. "You saved my life and I will forever be grateful to you," Emma said into the phone, her voice cracking with emotion. "Saved my life."
Stanford's neuromodulation therapy could be generally available by the end of this year, when scientists expect FDA approval. The technology is licensed to Magnus Medical, a startup with plans to commercialize it.
Williams, Stanford's principal investigator, says he's optimistic that insurers will eventually cover the new delivery model because it works within days and is therefore likely to be less expensive than traditional 6-week rTMS therapy. However, major insurers and Medicare currently cover rTMSsome plansPatients must demonstrate that they have exhausted other treatment options.
The next step is to investigate how rTMS could improve other mental health disorders, such as addiction and traumatic brain injury.
"I hope this study is just the tip of the iceberg," Siddiqi said. "I think we are finally on the cusp of a paradigm shift in the way we think about mental health care, where we will complement traditional chemical imbalance and psychological conflict models with a new model of brain circuitry."
In other words, electricity in the form of rTMS could become one of the vital tools used to help people with mental illness.
FAQs
What is the new experimental treatment for depression? ›
The remedy was a new type of repetitive transcranial magnetic stimulation (rTMS) called "Stanford neuromodulation therapy." By adding imaging technology to the treatment and upping the dose of rTMS, scientists have developed an approach that's more effective and works more than eight times faster than the current ...
Does electrical stimulation work for depression? ›Transcranial magnetic stimulation (TMS) is a noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. TMS is typically used when other depression treatments haven't been effective.
Which new treatment for depression involves magnetic currents? ›TMS is a noninvasive technological breakthrough that involves applying a series of short magnetic pulses to stimulate nerve cells in areas of brain known to be associated with major depression. The treatment for depression is sometimes called repetitive TMS (rTMS) because repetitive magnetic pulses are delivered.
What is ECT vs TMS treatment? ›TMS is an outpatient procedure, in which the patient stays awake the entire time and can be performed in a doctor's office in less than 30 minutes. ECT is a procedure typically administered in a hospital with the patient sedated under anesthesia and can require an inpatient stay.
What has been the most effective treatment for depression? ›Medications and psychotherapy are effective for most people with depression. Your primary care doctor or psychiatrist can prescribe medications to relieve symptoms. However, many people with depression also benefit from seeing a psychiatrist, psychologist or other mental health professional.
What therapy is most successful in treating depression? ›Cognitive Behavior Therapy (CBT)
This form of therapy is considered by many to be the gold standard in depression treatment.
The most common risk of e-stim is skin irritation where the electrodes are placed. However, there's a much more serious risk to heart health. For people with a pacemaker or other implantable heart device, e-stim may be dangerous and isn't recommended. E-stim is also not recommended for those who are pregnant.
Is electrical stimulation effective? ›Percutaneous electrical nerve stimulation and transcutaneous electrical nerve stimulation are effective for managing moderate and mild levels of pain. Spinal cord stimulation is used to treat persistent pain and ischemic limb pain.
Is electrical stimulation good for you? ›Added Benefits of EMS
To start, it can help reduce edema (swelling) and expedite the healing process of injured or damaged tissue. Electric muscle stimulation can also help reduce chronic pain. Other benefits include: May improve joint pain and swelling.
Electroconvulsive therapy (ECT) is a procedure, done under general anesthesia, in which small electric currents are passed through the brain, intentionally triggering a brief seizure. ECT seems to cause changes in brain chemistry that can quickly reverse symptoms of certain mental health conditions.
What is magnetic wave therapy? ›
Magnetic field therapy uses magnets to maintain health and treat illness. The human body and the earth naturally produce electric and magnetic fields. Electromagnetic fields also can be technologically produced, such as radio and television waves.
What is magnet therapy treatment? ›The term magnet therapy refers to the use of static magnets placed directly on the body, generally over regions of pain. A static magnet is an ordinary permanent magnet, as opposed to an electromagnetic coil.
Does insurance cover ECT? ›All health insurance companies cover ECT treatment, including Medicare. ECT is performed at highly regarded university and research medical centers including Harvard, Yale, Columbia, Duke, Mayo, UCLA and UCSF. MISCONCEPTION: ECT causes brain damage.
What are the side effects of electric shock therapy? ›The most common side effects of ECT on the day of treatment include nausea, headache, fatigue, confusion, and slight memory loss, which may last minutes to hours. These risks must be balanced with the consequences of ineffectively treated severe psychiatric disorders.
What are the pros and cons of ECT therapy? ›The Pros & Cons Of ECT
First and foremost, the treatment requires sedation, making recovery complex and much longer. Second, ECT has a higher chance to cause serious side effects for some individuals, including memory loss, which can deter potential patients. Pros of ECT: Safer today than previous ECT treatments.
Three of the more common methods used in depression treatment include cognitive behavioral therapy, interpersonal therapy, and psychodynamic therapy.
What is a brain stimulation device for depression? ›Deep brain stimulation works like a pacemaker, but it's used in the brain instead of in the heart. This technique requires surgically placing a small conductor, called an electrode, permanently in the brain. The electrode delivers a low level impulse that aids in regulating mood.
How did they used to treat depression? ›Various methods and drugs were recommended and used for the therapy of depression in the 19th century, such as baths and massage, ferrous iodide, arsenic, ergot, strophantin, and cinchona. Actual antidepressants have been known only for approximately 30 years.
Which type of therapy is often used to treat depression? ›Cognitive behavioral therapy (CBT)
According to research, CBT offers some of the most promising evidence for effective therapeutic treatment for depression available. It can help reduce symptoms of depression, but beyond that, it also helps prevent relapse.
CBT has been found to be effective in treating those with mild to moderate depression. It has also been proven effective when combined with other treatment options, like antidepressants or other medications.
What treatment is most successful for people who suffer from severe depression a depression that has been unresponsive to other treatments? ›
Psychological counseling. Psychological counseling (psychotherapy) by a psychiatrist, psychologist or other mental health professional can be very effective. For many people, psychotherapy combined with medication works best.
When should you not use electrical stimulation? ›TENS and EMS should not be used on vital parts, such as across the neck, chest or brain (and not at all if you have a pacemaker). Electrical stimulation should be used with caution during pregnancy or when trying to conceive. There is a potential of skin irritations and possibly burns if used excessively.
How long does electrical stimulation last? ›Conclusion: The recommended duration of electrical stimulation with percutaneous electrical nerve stimulation therapy is 30 min.
What does electrical stimulation feel like? ›Typically, electrical stimulation will feel tingly or prickly (some patients describe it as a comforting “pins and needles” sensation). Sometimes, as in the case when used for muscle strengthening, the intensity level can be high and somewhat uncomfortable, but it should never cause pain.
What are the four types of electric stimulation? ›Russian electrical stimulation. Neuromuscular electrical stimulation (NMES) Functional electrical stimulation (FES) Transcutaneous electrical nerve stimulation (TENS)
How often should you use electrical stimulation? ›You can safely use a TENS machine as often as you like. Usually for 30-60 minutes up to 4 times daily. TENS can provide relief for up to four hours.
What are the 3 main reasons we use electrical stimulation? ›Electrical stimulation is a type of physical therapy modality or treatment used to accomplish various tasks in physical therapy (PT). The idea is that applying an electrical current helps strengthen muscles, block pain signals, and improve blood circulation.
Is electrical stimulation FDA approved? ›All electrical stimulation devices are equally safe and have met the FDA guidelines. They are all considered Class II low risk devices.
What does electrical stimulation of the brain do? ›Because electrical charges are responsible for brain activity, electrical stimulation can in turn be used to change the brain's functioning. Brain stimulation has been used to treat mood disorders and stress, and it can even help people to solve problems, memorize information, and pay better attention.
What are the effects of electrical stimulation of the brain? ›Delivered to motor regions of the cerebral cortex, electrical stimulation can evoke a variety of first-order effects, including observable movements or an urge to move, or somatosensory, visual, or auditory percepts. In still other regions the subject may be oblivious to the stimulation.
Does electrotherapy for anxiety and depression work? ›
But however CES works, clinical studies report it is safe and effective, and most people who benefit from it typically experience results within a few days of starting treatment, Dr. Raab notes. Mild side effects may include headache, nausea, and dizziness.
What type of mental patients received electric shock therapy? ›ECT is used in the treatment of severe depression and other psychiatric disorders. At the University of Michigan, ECT is conducted under the direct supervision of a psychiatrist and anesthesiologist, and we implement modern monitoring devices and anesthetic medications to provide safe and effective treatments.
Could electroshock therapy be the most effective method of treating depression? ›ECT is among the safest and most effective treatments available for depression. With ECT, electrodes are placed on the patient's scalp and a finely controlled electric current is applied while the patient is under general anesthesia. The current causes a brief seizure in the brain.
Is magnetic therapy legit? ›Practitioners claim that subjecting certain parts of the body to weak electric or magnetic fields has beneficial health effects. These physical and biological claims are unproven and no effects on health or healing have been established.
Do magnetic bracelets help? ›There may be no physical health benefits to wearing metallic bracelets. They serve as placebos that help adjust your mental state when dealing with pain or illness. They do not reduce your pain's intensity. Some people with arthritis firmly believe that they work, despite the lack of scientific proof.
Does magnetic stimulation work? ›Does TMS work? Approximately 50% to 60% of people with depression who have tried and failed to receive benefit from medications experience a clinically meaningful response with TMS. About one-third of these individuals experience a full remission, meaning that their symptoms go away completely.
Do lymphatic bracelets work? ›So, do they really work? According to the vast majority of research, the answer is no. Davis' assertions and a 1976 study have been largely disproven, and there's little to no evidence that magnetic bracelets have any future in pain management.
Do magnets have healing powers? ›Magnets have no healing properties. Magnetic Resonance Imaging (MRI) employs very strong magnetic fields, far stronger than a household magnet can produce, and yet MRI's have no direct effect on the health of the patient (an MRI may have an indirect effect as a diagnostic tool).
How magnet therapy can treat depression? ›TMS stimulates the brain in targeted areas to decrease or eliminate depression symptoms. The treatment uses a series of short magnetic electrical pulses (also referred to as rTMS) to stimulate nerve cells in specific parts of the brain known to be associated with major depression.
Who is a good candidate for ECT? ›People who have had ECT before and responded well are good candidates for ECT. Other first-line indications for the procedure include people who are catatonic or suffering from a form of depression known as psychotic depression (depression associated with delusions and hallucinations).
Do you have to stay in hospital for ECT? ›
People often believed that they had to be admitted to hospital to have ECT, but staying in hospital is not always necessary, and people can have treatments like ECT as an outpatient.
Who is not a candidate for ECT? ›Not everyone is a candidate for treatment even if they believe ECT could help them. For example, children under age eleven cannot undergo ECT for mental health disorders. People with heart conditions and people who cannot handle short-acting sedatives or muscle relaxers should not undergo ECT treatments.
Can ECT cause long term damage? ›Longer-term side effects
loss of creativity, drive and energy. difficulty concentrating. loss of emotional responses. difficulty learning new information.
The most persistent adverse effect is retrograde amnesia. Shortly after ECT, most patients have gaps in their memory for events that occurred close in time to the course of ECT, but the amnesia may extend back several months or years.
Does ECT cause brain damage? ›The review of literature and present evidence suggests that ECT has a demonstrable impact on the structure and function of the brain.
What are three of the newest treatments for mental disorders? ›There is mounting research indicating that chemicals like psilocybin, MDMA, DMT and cannabidiol (CBD) can assist in treating mental illness that has not responded to conventional drug treatments when used in a controlled context and accompanied by professional care.
What is the new treatment for depression that reduces symptoms by at least 50% and requires no medication? ›Transcranial magnetic stimulation, or TMS, is a noninvasive form of brain stimulation. TMS devices operate completely outside of the body and affect central nervous system activity by applying powerful magnetic fields to specific areas of the brain that we know are involved in depression.
Which new treatment for depression causes remission in almost 80 percent of patients? ›A new treatment for depression, Stanford neuromodulation therapy, works eight times faster than the currently approved protocol and causes remission in nearly 80 percent of patients, according to recent research.