Brain stimulation therapies have proven successful at treating mental illnesses. This page includes treatments approved by the Food and Drug Administration as well as more experimental ones.
ECT is the go-to noninvasive brain stimulation therapy for depression. Used to treat severe, treatment-resistant depressive episodes in those 13 years or older.
Electroconvulsive Therapy (ECT)
Electroconvulsive Therapy (ECT) has long been used as an effective means to treat severe depression. The process requires being under anesthesia with electrodes attached to your head; electrical pulses then send directly into your brain that trigger seizures that rapidly relieve depressive symptoms and eliminate them altogether. Furthermore, it has proven more successful than antidepressant drugs when dealing with psychotic depression, such as hallucinations or delusions – and has even been demonstrated more successful at eliminating psychotic depression symptoms altogether.
Beginning its existence in 1938, ECT was developed by an Italian neurologist after noting the mood improvements experienced by patients suffering seizures due to epilepsy. He understood it was the chemical and electrical changes occurring within their brain caused by these seizures that helped patients. Treatment usually includes two to three sessions each week over several weeks in combination with medication.
Studies have demonstrated that electroconvulsive therapy (ECT) results in significant symptom improvement for up to 80% of patients receiving it. While there may be risks associated with ECT such as short-term memory loss (which typically improves within weeks), their likelihood is quite low; risks increase significantly for people who already have preexisting conditions like dementia or depression as a risk for this side effect.
Researchers have also observed that ECT causes widespread changes to brain volume in areas associated with mood disorders, likely related to activation of dopamine receptors in the brain. Of all forms of therapy available today, ECT seems to provide immediate antidepressant effects more rapidly than any other.
ECT typically involves administering anesthesia and administering muscle relaxants in order to decrease muscle spasm intensity. A physician then determines an optimal stimulation level through an iterative process called “dose titration.” For optimal effectiveness, stimulation levels should exceed your individual seizure threshold thresholds.
Electroconvulsive therapy (ECT) treatments typically occur in a designated ECT suite, post-anesthesia care unit or outpatient surgery center on an outpatient basis. You must abstain from food and liquid intake for six hours before arriving at your appointment time in order to complete paperwork and prepare for anesthesia.
Transcranial Magnetic Stimulation (TMS)
TMS (Transcranial Magnetic Stimulation) is a noninvasive procedure that uses electromagnetic fields to target areas involved with mood regulation in the brain. Approved since 2008 as an FDA treatment option for depression, TMS may prove especially helpful among those who do not respond well to antidepressant medications. An rTMS session typically involves placing an electromagnetic coil over an area of your brain known to regulate mood regulation and depression. Magnetic pulses generated by a stimulation device – similar to an MRI scanner’s 70 mm figure 8 coil – are delivered through the scalp by means of TMS to stimulate nerve cells that connect deeper parts of the brain responsible for mood. TMS treatment is painless and does not require anesthetic or sedation for use.
Studies have demonstrated the efficacy of repetitive TMS for treating medication-resistant depression; however, its full course can be challenging for individuals who work or have other obligations such as child care responsibilities; additionally, patients may experience debilitating side effects during the treatment period that make them unwilling to continue or discontinue the course altogether. As a result, researchers are actively searching for methods to optimize TMS delivery schedules and reduce response times.
To reduce the duration of TMS treatments, new protocols have been created which provide multiple short sessions each day or week instead of just a single daily one. These accelerated TMS regimens have shown comparable or greater efficacy than standard regimens despite still remaining unclear about how exactly it works.
Neuronavigation or “brain mapping,” one of the most promising developments, uses structural MRI scan results to guide a magnetic coil directly to the specific brain region that needs stimulating. This allows patients greater freedom when scheduling TMS treatments – including accommodating work or family obligations.
Other promising advances include combining targeting with E-field modeling, which allows for optimal coil orientation on the brain based on individual skull structure and TMS coil location. This may also help optimize magnetic field strength for each person individually to increase treatment efficiency further.
Transcranial Direct Current Stimulation (tDCS)
Transcranial Direct Current Stimulation (tDCS) is a noninvasive therapy that utilizes electrodes placed on the head or neck and applying low electrical current, in order to increase or decrease resting membrane potential of neurons in different brain regions, making firing easier or harder respectively. Furthermore, currents from electrodes placed over them may alter how neurotransmitters bind with receptors within your nervous system thereby altering mood and cognition.
Researchers have combined tDCS and rTMS as an effective treatment strategy for depression. According to one study, using both treatments together resulted in significantly lower HDRS-24 total scores both post-intervention and 1-month follow-up periods compared to either treatment alone; it also led to more responders and better remission rates than either rTMS or active tDCS alone.
tDCS works by increasing neurotransmitter concentration in certain regions of the brain, with its effects lasting for hours after stimulation has been applied. Unlike some frequency therapies, tDCS is noninvasive and typically only produces temporary side effects such as burning sensation at electrode sites or headaches – both are short term issues.
Studies of transcranial direct current stimulation for depression have demonstrated its benefits by showing it can significantly enhance mood in those suffering from persistent or treatment-resistant depression, and can enhance cognitive performance by strengthening working memory efficiency. Unfortunately, however, these benefits cannot be distinguished from collateral reduction of depression itself.
Recent research demonstrated that transcranial Direct Current Stimulation (tDCS) was more effective than placebo at treating recurrent depression among individuals who had failed to respond to two courses of antidepressant medication. The trial included six weeks of daily tDCS followed by a three-week sham treatment phase, where participants and raters were unaware of which treatment allocation had been received. Participants treated with the tDCS treatment showed significant improvements in depressive symptoms comparable to responses seen in open-label studies such as Sequenced Treatment Alternatives Relieve Depression (STAR*D).
tDCS also boasts an economical and user-friendly administration process, being administered by trained clinicians with basic equipment – with no major risks involved with its administration.
Magnetic Stimulation Therapy (MST)
Magnetic Seizure Therapy* (MST) is an innovative new approach that combines the benefits of electroconvulsive therapy (ECT) with minimal memory or cognitive side effects. A magnetic coil will be placed over your head under general anesthesia during MST; then magnetic pulses generated from that coil produce brain waves with much smaller impact than those created by ECT, producing brain waves much more locallyized than its waves while producing far fewer cognitive issues such as memory loss or confusion.
MST remains in research phase, yet has already shown itself to be just as effective as ECT for treating depression. Furthermore, its use has also been investigated in other psychiatric disorders like bipolar disorder and schizophrenia with promising results thus far.
Researchers tend to emphasize MST’s efficacy; however, several studies have also explored its safety. This review is one of the first to focus on MST safety data in order to gain a more balanced perspective of this promising technique.
The authors conducted a comprehensive literature search in eight databases (PubMed, Embase, Cochrane Library, Web of Science, CBM, CNKI and VIP) to identify trials that fulfilled their inclusion criteria. All eligible titles and abstracts were then assessed for relevance before their full texts were obtained if needed – 19 studies made the cut in their analysis.
Study results indicated that MST was safe to use among medically stable individuals who required anesthesia, although potential side effects have included headache, dizziness, nausea or vomiting, fatigue and muscle aches that were possibly triggered by either the anesthesia itself or by MST itself. Therefore it is vital that any potential risks or benefits of MST treatments with your physician and they can recommend which therapy would be most suitable for you.
