If this is not your name, click here.
| | If this is not your name, click here. | | |
| | Contact Us | Order Now | Journals | Bookstore | Register a colleague | | |
| |  Magnetic Stimulation May Be as Effective as Electroconvulsive Therapy for Severe Depression CHICAGO, IL -- January 30, 2002 -- Repetitive transcranial magnetic stimulation, which delivers brief but intense magnetic pulses to the brain, may be as effective as traditional electroconvulsive therapy in treating severe depression, according to a study out of the University of Illinois (UIC) at Chicago. Dr. Philip Janicak, medical director of UIC's Psychiatric Clinical Research Center and head of the clinical trial, says repetitive transcranial magnetic stimulation (rTMS) appears to produce fewer harmful side effects than electroconvulsive therapy, better known as shock treatment. The preliminary results of the UIC trial will be published in a forthcoming issue of Biological Psychiatry. In rTMS, a physician uses a hand-held wire coil to produce a controlled, rapidly fluctuating magnetic field with a strength of 1.5 to 2 Tesla, about the same strength used in magnetic resonance imaging but more focused. The coil is placed over the left prefrontal cortex, an area of the brain behind the forehead that typically shows abnormal electrical activity and decreased blood flow in depressed patients. The magnetic pulses pass through the skull into this targeted area. The procedure lasts about 10 to 15 minutes, during which about 1,000 stimulations occur. Compared with electroconvulsive therapy, which works by inducing a seizure, rTMS is relatively benign, according to Dr. Janicak. Sedation is not required, and patients do not appear to experience deterioration in memory or cognition, standard side effects of shock treatment. However, there is a very small risk of an inadvertent seizure. "Patients might feel their facial muscles contract at the time of treatment and may have a mild headache afterward, but that's all," Dr. Janicak said. A total of 25 patients with either bipolar depression or unipolar depression have thus far participated in the UIC study. They were randomly assigned to undergo a course of either transcranial magnetic stimulation (10 to 20 treatment sessions) or bitemporal electroconvulsive therapy (four to 12 treatments). Following treatment, the patients were assessed using the Hamilton Depression Rating Scale, a test that evaluates mood, feelings of guilt, agitation, sleep problems, work capacity and interest, as well as other symptoms of depression. Both groups of patients showed significant improvement in their baseline depression scores, with a 55 percent reduction on the Hamilton Depression Rating Scale for the rTMS group and a 64 percent reduction for the electroconvulsive therapy group. The difference between the two groups was not statistically significant. The two groups also performed similarly on other clinical measures of mood and behavior. "rTMS is a promising alternative, particularly for the many severely depressed patients who do not benefit from or tolerate current established treatments," said Dr. Janicak. According to Dr. Janicak, how rTMS works is still not clear. One theory suggests that the magnetic stimulation increases blood flow and chemical activity in the affected area of the brain. Depression is common in the United States. Up to 20 percent of the population will experience at least one episode of depression over a lifetime. Further, as many as one-third of these episodes will be severe or not managed adequately by existing treatments. SOURCE: University of Illinois at Chicago
|
