RTMS, magnets against depression

Depression can have many causes and many triggers, in the Netherlands alone there are 750,000 depressed people in 2012, yet in most cases the signals in certain parts of the brain appear to differ from those of non-depressed people. Reason to see whether this area can be stimulated, this has developed into a process called rMTS, or repetitive Transcranial Magnetic Stimulation, stimulating a part of the brain with a magnet near the left prefrontal cortex.

How does rTMS (repetitive transcranial magnetic stimulation) work?

rMTS works by means of a magnet that switches on and off very quickly. Patients experience it as if someone taps their head very quickly with a pencil. The attending physician slowly moves the magnet around in search of the area that specifically controls the movements of the left thumb. As soon as the magnet reaches this part of the brain, the patient will move his or her thumb in the rhythm of the ‘flashing’ magnet. Then the doctor knows that he is close to the area he needs, an area the size of a sugar cube, the place that plays the leading role in reward and approach behavior. The problem with most depressed patients is that this area works less well or not at all, so that one never gets a good feeling from, for example, eating something tasty or helping a friend or simply enjoying the sun. The magnets cause induction in the brain and because the magnet turns on and off so quickly, the magnetic field changes and generates electrical voltage in conductive materials such as nerve cells. Talk therapy is linked to this process, 75% of people recover from the therapy and it has a long-lasting effect of 15 to 25 sessions. It can help for months to years. I would also definitely recommend watching the following video to get a better idea of the entire process: rMTS

Electroshock therapy, the precursor to rTMS

The predecessor of rMTS had the same principle as rMTS, electroshock therapy gave psychiatric patients an electric shock through the head to make them ‘normal’ and ‘manageable’ again. To a certain extent this also had the desired effect, were it not for the fact that it was widely abused in psychiatric care, it was done without anesthesia and there were unpleasant side effects, such as nausea and memory problems. However, electroshock therapy is still useful today, but only under anesthesia and in depressed patients who have severe anxiety and panic attacks during most of their day and simply do not want to eat or drink. rMTS, however, is a technique with fewer side effects and much more patient-friendly. Besides the fact that it is not painful, it can also be much more targeted and precisely direct the energy of the magnet to only address the problem area. At worst, you may experience a bit of a headache, which will disappear with a little paracetamol.

Health Council

The Health Council is very positive about this system, the figures don’t lie and it is even possible that people with other psychological problems can be helped, such as people who hear voices or unwanted muscle tremors such as Parkinson’s. In the case of Parkinson’s, for example, the magnet will ensure that the brain area involved sends fewer signals. So many possibilities.

Criticism

However, this treatment method is still in its infancy in 2012 and is still being tested. It is still available to everyone, but there are a number of conditions. Mild depression is not eligible and Electro Shock Therapy must have been tried. People must also meet certain requirements with regard to their complaints. Reason to stay alert and turn everything inside out. There are also people who suggested that this method would have a placebo effect because people would like to believe that it would indeed work and in fact think themselves better with this thought. The placebo effect has been known for years and is also the method to find out whether, for example, medications have (sufficient) effect on certain problems. So they wanted to exclude this from rMTS, in some people a metal plate was placed in front of the magnet, something that was impossible to recognize as such, and a session of these tests were performed. What seems? rMTS indeed works! But the effect is still minimal and the chance of relapse is still high. This treatment method therefore still needs to undergo a lot of development if it is to have a better effect than anti-depressants. The tests that took place in 2007 were only tested on 300 people for whom anti-depressants did not work.

The numbers

As already indicated, rMTS works about as well as anti-depressants, except that only 30 to 50% of people who need anti-depressants actually work. After 20 sessions over approximately 6 months, 77.6% feel a significant improvement of around 50% in mood.

Figures based on 49 patients in the long term (6 months after treatment):

  • Thirty-six people were able to participate in the test because the treatment was successful, this is 73.5%.
  • Seventeen of these patients were still doing very well. Their past treatment still worked.
  • Nine patients showed a relapse.
  • One patient still had maintenance treatments.
  • Nine patients did not respond or did not want to participate in the test.