A treatment called transcranial magnetic stimulation (TMS) can help depression, researchers say, even if antidepressants have failed. However, some have questioned whether the technique really works, says Dr. Mark S. George of the Medical University of South Carolina in Charleston. According to the skeptics, it is very hard to fake the sound and feeling of a TMS treatment, making it difficult to do a placebo treatment without patients being aware of it. As long as people know they are getting the real treatment, it is difficult to rule out that they may have thought it worked simply because they believed it would.
George and his team believed they have solved this problem, however. They have developed a dummy device which clicks in a similar way and causes a person's eye muscles to twitch just like the real device.
Using this new device, the team conducted a new 190-person study - with half of the participants receiving 37.5 minutes of TMS therapy and half receiving 37.5 minutes of the sham treatment - once a day for three weeks.
After three weeks, 14% of the patients receiving the actual TMS treatment recovered from their depression, compared to 5% who had received the sham treatment. In other words, people who received the real treatment were four times more likely to get better than those receiving the fake treatment.
In the second phase of the study, all patients received TMS, with 30% of the patients receiving relief from their depression.
George said it was not clear how long treatment should last, but that it looked like patients should be treated at least three weeks, and perhaps even six weeks, in order to determine if it will work for them.
TMS works, according to George, by producing an electrical current that can pass through the skull into a target area of the brain. It is believed to work by "resetting" electrical activity of the brain, restoring normal mood regulation.
George says he hopes that when we better understand what area of the brain to target and at what dose and duration of treatment, success rates will improve even more, approaching the success rates currently seen with ECT, a treatment which uses an electric shock to trigger a convulsion while a patient is under anesthesia. About 60-70% of patients treated with ECT recover from their depression. With better success rates, TMS might be a less invasive alternative to ECT once it is fully developed.
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