SIOUX FALLS, SOUTH DAKOTA —
Currently, electroconvulsive therapy (ECT) has been used as a last line of defense for certain types of chronic depression that don’t respond to other forms of therapy, such as by the use of medication or through counseling methods. However, a new method for treating this potentially debilitating condition is becoming more readily available, a treatment that does not need to induce a seizure in order to be effective. This treatment method is called transcranial magnetic stimulation TMS), and uses alternating magnetic fields to stimulate certain cells in the brain to alleviate symptoms of depression.
Approved for use by the Food and Drug Administration (FDA) in 2008, transcranial magnetic stimulation can actually penetrate the skull to create electrical stimulation inside the brain. Unlike the use of ECT, those who undergo treatment with TMS have no need for general anesthesia or the induction of a seizure to receive effectiveness from this kind of therapy.
Electrical currents cannot readily pass through the skull. In order for electroconvulsive therapy to be effective, larger amounts of current are applied than necessary just for an appropriate amount of current to reach the target area of the brain. Also, because the bone and tissue diffuse electrical current, targeting of specific areas is not possible, and a more general area is treated with ECT.
With transcranial magnetic stimulation, alternating magnetic fields can pass directly through the skull and into a specific area of the frontal lobe of the brain to stimulate neurons to create the desired result. Treatment with TMS causes fewer side effects than traditional ECT, including cognitive side effects.
Those who receive TMS can expect an outpatient procedure with little discomfort and no need for the use of anesthesia. During treatment with TMS, an electromagnetic coil is placed against the head and brief magnetic pulses are sent through the brain. Even though earplugs are used, the patient will hear clicking sounds and feel a tapping on the scalp. Some irritation may be felt during and after treatment. This procedure is currently used at the Mayo Clinic, whose doctors estimate six weekly treatments lasting approximately 40 minutes each time.
Treatment with TMS is growing, and is even covered by some insurance companies. As this therapy continues to be studied for its effectiveness, not only for its use in depression, but in other disorders involving the brain, the use for ECT may become obsolete in favor of less harmful methods such as TMS.