Since the start of the coronavirus pandemic, the issue of mental illness, including depression, has received increased attention. best ever. Transcranial magnetic stimulation, a new treatment option specifically for depression, is gradually addressing some of these significant unmet needs in our community.
Research is also exploring the use of transcranial magnetic stimulation in a number of other conditions, including obsessive-compulsive disorder, autism, attention-deficit hyperactivity disorder, chronic pain, and possibly slowing the progression of dementia symptoms. I am.
What is known so far about this new treatment, and does it live up to its promise for patients with depression?
How does it work and who is getting it now?
transcranial magnetic stimulation It involves applying a series of magnetic pulses through a coil placed on the scalp. While the patient wakes up and sits relaxed in a chair, the magnetic field activates nerve cells in the brain, gradually changing the activity of brain circuits disrupted by depression. This is thought to help restore normal interactions between brain regions.
The side effects are usually calm And temporary. These may include scalp discomfort, headaches, tingling or facial twitching, and brief periods of lightheadedness after a treatment session.
There is consistent evidence that effect A study of transcranial magnetic stimulation therapy for acute episodes of depression. Its use is supported by numerous clinical trials and real-world studies that have shown it to be more effective. 50% of patients receiving treatment. It raised money for Medicare a few years ago and is now being gradually rolled out across Australia.
However, several issues remain with the use of transcranial magnetic stimulation therapy. First, patients come to the clinic every day, Monday through Friday, for four to six weeks. This is inefficient and costly.
Both of these problems may eventually be solved by the development of what are called “accelerated” protocols, or treatments that administer higher doses over fewer days. A patient may receive 4 to 5 days of high-dose treatment per week, rather than having the entire treatment dose spread over more than a month.
the study Delivery is becoming more efficient both domestically and internationally. Very rapid clinical benefit With these new treatments.
What about other conditions?
In parallel with the clinical development of transcranial magnetic stimulation for depression, research is demonstrating the potential value of transcranial magnetic stimulation in other conditions.
A series of studies shows that a somewhat different type of transcranial magnetic stimulation, which can stimulate deeper regions of the brain but also comes from scalp-based coils, is effective in treating symptoms in some patients with the disease. This was demonstrated. Obsessive-compulsive disorder (OCD). This is an important development because many people with OCD fail to improve with medication or psychotherapy, and few new treatments for the condition have been developed.
Transcranial magnetic stimulation for OCD approved Intended for clinical use in the United States and available in a limited number of clinical services in Australia.
This treatment has shown the following effects addiction disorderincluding the development of approaches using transcranial magnetic stimulation. Help patients quit smoking. Initial trials of this approach showed that the proportion of patients who did not smoke in their first six weeks at least doubled.
Transcranial magnetic stimulation may also be helpful in managing chronic pain. Multiple approaches using technology are promising; Guidelines are coming outHowever, a consistent clinical pathway is still not clearly defined.
A group led by researchers from all over the country. Professor Peter Enticott of Melbournehas conducted world-leading research attempting to develop methods of using transcranial magnetic stimulation to assist adolescents and adults with autism, particularly to improve social understanding and interaction abilities. I am.
As the clinical need grows, early studies are also investigating whether transcranial magnetic stimulation can reduce symptoms. attention deficit hyperactivity disorder (ADHD).
Research has already demonstrated that transcranial magnetic stimulation can at least temporarily improve thinking ability in a variety of disorders, including: Alzheimer’s disease. This is currently being applied to see if it is possible to improve attention in ADHD patients. For now, this research is still in its early stages.
Will the effects last?
So far, the quality of evidence There are still gaps in the sustainability of the effects of transcranial magnetic stimulation in depression and the need for maintenance therapy. Studies are looking at whether reducing the frequency of continuous transcranial magnetic stimulation (for example, once every two weeks of treatments) can prevent depression recurrence in patients who respond well. Preliminary investigation Although some suggest that maintenance therapy is effective, there is insufficient high-quality research to convince Medicare to subsidize it.
Medicare funding also does not fund the provision of transcranial magnetic stimulation to patients who experience multiple relapses of depression.
This is extremely rare. Patients with depression can receive multiple courses of antidepressants, psychotherapy, or electroconvulsive therapy based on similar levels of evidence. This also applies to most other medical therapies.
in clinical settings, and limited evidence available, it seems clear that if a patient has responded to transcranial magnetic stimulation once, they are likely to respond again. Until this issue is resolved, patients are left in an unenviable situation. They already know that there are effective treatments that work for them, but access to them comes at a significant cost or requires long-term hospitalization in private hospitals.
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