London: A new MRI technique that delivers magnetic stimulation to the brains of people with severe depression may help ease symptoms for at least six months, which could vastly improve their quality of life.
The results of the trial, published in the journal Nature Medicine, found that on average, participants showed substantial improvements in the severity of their depression, anxiety and thinking with better function and quality of life over 26 weeks with MRI neuro-navigated Transcranial Magnetic Simulation (TMS).
TMS is an outpatient treatment where people have powerful magnetic pulses delivered to the left side of their head just in front of the temporal area of the scalp.
The person is conscious and has 20 sessions over a four-to-six-week period.
The method has been used since the 1980s to treat people with severe depression but by targeting the precise area of the brain where stimulation is thought to be helpful, we now have evidence for a longer lasting benefit of this treatment, said the team from the University of Nottingham in the UK.
The team used neuronavigation, a computerised tracking system using light to deliver the TMS, which is a way of precisely pinpointing the area of stimulation so that the same area is targeted at all 20 treatment sessions.
Over two thirds of participants responded to the treatment, with a third showing 50 per cent improvement in terms of their symptoms and a fifth managing to move into remission and stay there. “Patients who responded to the treatment could stay relatively well compared to how they were previously, with as little as one or two treatments a year,” said Richard Morriss, Professor of Psychiatry in the School of Medicine at the varsity.
“The changes we saw were substantial, not only in reducing their depression symptoms, but they were large enough to improve concentration, memory, anxiety and subsequently their quality of life,” he added.
Major depression is the leading cause of disability lost years worldwide, and suicide from depression is the biggest killer in people aged between 15-49.
Antidepressants and therapy delivered as first or second-line treatments help two thirds of people with depression, but the remaining third have treatment resistant depression (TRD).
This is defined as a lack of response to two courses of antidepressants.
The trial, which included 255 participants, suggests this might be achieved using functional MRI with TMS to define the exact area of the brain to hit.
MRI is not normally used to deliver this treatment.
“Given these patients are people who have not responded to two previous treatment attempts and have been ill for an average of 7 years, to get such a significant response rate and a fifth who have a sustained response is really encouraging,” Morriss said.
“Since the magnetic pulse can be focused, there are usually only minor short-lasting side-effects, and the person can return to their daily activities immediately on return from the hospital,” he added.