Tuesday, October 26th, 2010
Magnetic Stimulation Benefits Depressive Patients Long Term
Reported from HealthDay.com
Transcranial magnetic stimulation, a noninvasive, non-drug therapy that has been shown to be successful for acute relief of depressive symptoms, appears to have durable long-term benefits as well, according to research published in the October issue of Brain Stimulation.
WEDNESDAY, Oct. 20 (HealthDay News) — Transcranial magnetic stimulation (TMS), a noninvasive, non-drug therapy that has been shown to be successful for acute relief of depressive symptoms, appears to have durable long-term benefits as well, according to research published in the October issue of Brain Stimulation.
Philip G. Janicak, M.D., of the Rush University Medical Center in Chicago, and colleagues shifted 142 patients who had responded to six weeks of acute TMS therapy to three weeks of tapering and initiation of maintenance antidepressant therapy to determine if TMS has long-term benefits for the treatment of major depressive disorder.
The researchers found that, after a three-week tapering of TMS, 99 patients underwent a subsequent 24-week period, during which, relapse occurred in only 10 patients. Reintroduction of TMS treatments appeared to prevent relapse in 32 of 38 patients who experienced a worsening of symptoms.
“These initial data suggest that the therapeutic effects of TMS are durable and that TMS may be successfully used as an intermittent rescue strategy to preclude impending relapse,” the authors write.
The research was supported by a grant from Neuronetics Inc.; one author is an employee of Eli Lilly. Several authors disclosed financial relationships with Neuronetics, Eli Lilly, and other pharmaceutical companies.
Tuesday, October 26th, 2010
Magnetic Stimulation May Improve Mood Disorders
By Better Health Research News Desk • Oct 25th, 2010
The use of magnetic waves may alleviate symptoms of mood disorders, according to a study published in the journal Brain Stimulation.
Transcranial magnetic stimulation (TMS) is a procedure that conducts electrical pulses, which are directed to stimulate certain lobes of the brain. Areas affected by this treatment increase mood-enhancing compound levels, such as dopamine, norepinephrine and serotonin.
Over the course of three weeks, a total of 301 patients with mood disorders received the electrical waves five days each week, once every day. These individuals remained awake during TMS, and didn’t need anesthesia or sedation medication.
The participants reported that they had an improved outlook on life, were less depressed and capable of leading a more normal lifestyle.
Murali S. Rao, lead author of the research, stated that “the electrical pulses target the nerve cells in the region of the brain called the left prefrrontial cortex, the region of the brain that regulars our moods.” He added that “the pulses are mild and painless and patients are able to immediately return to normal activities.”
Another natural alternative to treating mood disorders is practicing tai chi, a low-impact for of martial arts, according to a study conducted at the Tufts University School of Medicine
reported by www.southshoretms.com
Friday, October 8th, 2010
Reported in CHICAGO (Reuters) – New depression treatments favor a tailored approach and include recommendations for the use of shock therapy and other alternatives, including exercise when people fail to get relief from drugs.
The guidelines, issued on Friday by the American Psychiatric Association, are the first update on depression treatment in more than a decade.
“The five-year process of intense review, discussion and thoughtful revision-making has led us to today’s release of new guidelines that we believe will improve patient care,” Dr. Alan Gelenberg, an Arizona-based psychiatrist who led the group that drafted the guidelines, said in a statement.
“We are hopeful these guidelines will lead to improved lives for many patients.”
The panel searched more than 13,000 scientific articles published between 1999 and 2006 to craft the new guidelines.
Among the changes, the researchers recommend:
* Doctors should use rating scales to assess their patients’ conditions and tailor treatment according to the severity of symptoms. They can adjust various strategies such as medication, healthy behaviors, exercise and therapy.
* For people who repeatedly fail to benefit from drugs, the guidelines recommend use of electro-convulsive or so-called shock therapy, which has the most scientific data supporting its use.
* The recommendations also added newer treatments, including transcranial magnetic stimulation, which uses highly focused, pulsed magnetic fields to restore function to stimulate brain regions linked with depression.
Privately held Neurotonics Inc’s NeuroStar device was approved for this use by the U.S. Food and Drug Administration in 2008.
* Researchers also recommend use of vagus nerve stimulation, such as a device made by Cyberonics Inc, which delivers electrical stimulation to the vagus nerve, a major nerve linking the brain to internal organs.
* The guidelines also recommend regular exercise, which studies have shown can reduce depressive symptoms, especially in older adults or those with chronic medical problems.
* They recommend more frequent use of maintenance drug treatment, especially for people whose depression is likely to recur. This is especially important for people who have had three prior episodes of depression or chronic illness.
In a separate report, the U.S. Centers for Disease Control and Prevention said on Thursday that about 9 percent of U.S. adults surveyed in 2006 and 2008 had current symptoms of depression, including 3.4 percent who had symptoms of major depression, in which a person reports having five or more depressive symptoms for at least two weeks.
The survey included more than 235,000 people in 45 states, the District of Columbia and two U.S. territories.
Of these, only 4.8 percent of North Dakota residents were depressed, compared with 14.8 percent of those in Mississippi.
Overall, depression affects more than 13 million U.S. adults each year and costs billions of dollars to treat in costs for treatment, loss of productivity, workers compensation and death.
By Julie Steenhuysen Julie Steenhuysen – Fri Oct 1, 10:24 am ET
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Tuesday, October 5th, 2010
Reported on September 22, 2010 (San Francisco, California) — A pilot study of a novel treatment for poststroke aphasia suggests repetitive transcranial magnetic stimulation (rTMS) may help prevent activation of areas in the brain that may hinder recovery in these patients.
In the small proof-of-concept study, aphasic stroke patients treated with rTMS also showed improved performance on language tests when compared with a control group, said presenting researcher Nora Weiduschat, MD, MPH, assistant professor of neuroscience in radiology at Weill Cornell Medical College in New York City.
Their results were presented at the American Neurological Association 135th Annual Meeting.
The study was initiated with the goal of attempting to suppress activation in the brain’s right hemispheric structures, a phenomenon that hinders optimal functional reorganization in aphasic stroke patients, said Dr. Weiduschat, formerly of the University of Cologne in Germany, where the study was conducted.
“The idea was to suppress this right hemispheric activation in order to optimize outcomes,” she said. Although there have been case studies of rTMS in aphasia in stroke patients, this was one of the first double-blind randomized controlled trials to test the intervention, Dr. Weiduschat said.
During the study, 6 patients received 10 sessions of rTMS of 1 Hz for 20 minutes over the right Brodmann area (BA) 45 of the brain, whereas control patients had a sham treatment applied over the vertex, an area of the brain thought to have little effect on language, during 2 weeks.
Each rTMS session or sham treatment was delivered shortly before all patients (both in the intervention and sham groups) received conventional speech therapy. At baseline and after the treatment period, regional cerebral blood flow at rest and during an acoustic verb generation task was imaged with HSO positron emission tomographic scans in all patients.
Results indicated that at baseline, activation in the left and right BA 45 was comparable in both groups. But after the treatments ended, functional activity increased in the right BA 45 in the sham group, signaling that activation had shifted farther to the right in the brain.
In the rTMS intervention group, however, the researchers saw no further shift toward the right hemisphere, and patients who received rTMS also showed a trend toward a shift to the left BA 45, although this trend was not statistically significant, Dr. Weiduschat said.
The researchers were expecting to be able to document through imaging whether or not rTMS might hinder activation of brain regions associated with language problems in stroke patients, but they were surprised to find that those treated with rTMS also showed improved clinical outcomes.
When tested with the Aachen Aphasia Test, which measures verbal comprehension and speech generation, the control group improved by 8 points, whereas the rTMS group’s scores improved by 20 of a possible 100 points. “It is a small study, so we were surprised to see clinically significant effects, or a 20% improvement in outcomes,” Dr. Weiduschat said.
The researchers hypothesize that although rTMS may influence cortical activation in aphasic stroke patients in a positive way, speech therapy may help make these changes long-lasting. “We don’t think that rTMS will replace speech therapy, but it might be a useful addition,” Dr. Weiduschat said.
She noted that the researchers plan to perform a larger study to identify those patients who might benefit most from rTMS — for instance, patients with different types of aphasia or those with lesions in certain locations in the brain. “With a larger sample size, you could find indications and contraindications for rTMS,” she said.
“This study provides a fascinating preliminary result that should be further explored in a larger study,” commented Steven R. Levine, MD, professor and vice chair of neurology at the State University of New York Downstate College of Medicine in New York City. “It’s a small trial, so it’s hard to say anything definitive from it, but it’s a novel and significant approach,” he said.
However, Dr. Levine noted that using rTMS for stroke patients would demand special expertise in this technology that not every hospital neurology department would have at its disposal.
“With such a small group as in this study, it’s hard to know how carefully selected these patients were,” he added. “But there seems to be a significant biological effect as well as a significant improvement in clinical outcomes. It seems believable, but I’d like to see it substantiated with larger numbers.”
The study was supported by the Wolf-Dieter Heiss Foundation and the Marga and Walter Boll Foundation. Dr. Weiduschat and Dr. Levine have disclosed no relevant financial relationships.
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