College of Physicians and Surgeons
Despite advances in psychopharmacology, major depression remains a significant public-health problem and a substantial proportion of patients do not respond to conventional treatments. Electroconvulsive therapy (ECT) plays an important role in the treatment of severely depressed patients, especially in those who do not respond to antidepressant medications. However, its use is limited by cognitive side effects. The dosage of the electrical stimulus and the anatomical placement of the stimulating electrodes are critical in determining the efficacy and cognitive side effects of ECT. However, control over the spatial distribution and magnitude of intracerebral current density is limited by high skull impedance, which shunts the majority of the electrical stimulus through the scalp and cerebrospinal fluid. Repetitive transcranial magnetic stimulation (rTMS) induces electrical current in the cerebral cortex with rapidly alternating magnetic fields. Magnetic fields penetrate the scalp and skull with no resistance, offering greater precision in the spatial extent and intensity of stimulation. Relative to conventional ECT, magnetic seizure induction may offer greater control over the site of seizure initiation and extent of cortical stimulation. In an IRB-approved study, we performed the first trial of magnetic-seizure therapy (MST) for the treatment of depression. We are continuing this work in a controlled trial, examining the cognitive side effects of MST compared with ECT.
Project Leader/Principal Investigator
Department of Psychiatry
Swiss National Science Foundation
University Hospital of Berne - Dept of Psychiatry
University of Bonn, Germany?Dept of Psychiatry; Charite Hospital, Berlin, Germany?Dept of Psychiatry
National Institute of Mental Health (NIMH)