Neuro-Procedure Succeeds in Treating Depression
Doctors at Walter Reed Army Medical Center are using an electrical stimulation device that looks like a high-tech dentist's chair to successfully treat some of their patients with depression. Doctors around the world are following the research on the pioneering medical treatment to determine its full potential.
The device, called a repetitive Transcranial Magnetic Stimulation (rTMS) system, utilizes a phenomenon known as electromagnetic induction - the rapid changing of magnetic fields - to create small electric currents that essentially jump-start the brain.
Magnetic pulses are aimed at the prefrontal cortex of a patient's brain, where mood regulation is controlled, at rates faster than one pulse per second. As these pulses penetrate brain tissue, they create electric currents that excite neurons and ultimately stimulate nerve cells to trigger brain activity.
Lt. Col. Geoffrey Grammer, M.D., who is chief of inpatient psychiatry at Walter Reed, said rTMS offers him a new line of treatment for some of his patients with the worst cases of depression.
"TMS offers hope to the men and women in the armed forces who have tried a multitude of treatment options with little success," Grammer said. "It's not a cure-all, but for the patients that it works on, it's simply amazing."
Grammer said that 24 patients have been treated with TMS at Walter Reed so far, and that 500 TMS procedures have taken place.
A New Kind of Therapy
Grammer says that when successful, the results can be astounding.
"I watched one patient go through the process from beginning to end," Grammer said. "By the time she completed therapy she literally began looking and acting like a new woman."
Although many patients see phenomenal results, about half require a follow-up phase within six months of the therapy. If symptoms return, Grammer will offer a three-week "maintenance phase."
TMS therapy was originally developed, tested and cleared by the U.S. Food and Drug Administration in 2008 to treat depression, but Grammer thinks there are other applications for the technology. He is currently compiling a team of researchers to develop new uses for the system and continue his research on the therapy, which is not widely available in hospitals.
For example, Grammer thinks the treatment could also be used to "exercise the brain" of traumatic brain injury patients, much in the same way physical therapists exercise damaged limbs.
He also believes the stimulation could have applications for post-traumatic stress disorder patients and service members with post-amputee pain syndrome. The potential benefits, he speculates, could forever change the way mental health issues in the military and the civilian sectors are addressed.
While other applications are in the process of being developed, there are many service members who might greatly benefit from getting rTMS treatment now, according to Grammer.
With practically no side effects, no risk of long-term health concerns and high efficacy ratings, rTMS could potentially extinguish the remaining barriers that inhibit service members from seeking mental health treatment, Grammer said.