Magnetotherapy for depression is available on the NHS, here’s how it works

Magnets to cure depression? It may seem strange but this treatment is now available on the NHS. It’s called transcranial magnetic stimulation, or TMS.

For people who have tried antidepressants but it didn’t work, TMS may be offered. It involves zapping areas of the brain associated with depression with pulsating magnetic fields.

Treatment usually involves daily half-hour sessions five days a week for two to six weeks.

TMS is not only used to treat depression, it has been used as a diagnostic tool for multiple sclerosis and motor neuron disease. And its effectiveness in treating mood disorders, such as depression and anxiety, has been studied for more than 30 years.

It works by sending a magnetic pulse into the brain through a device placed on the skull.

Develop the right device

So-called refractory depression that doesn’t respond to antidepressants or talk therapy can be treated effectively with electroconvulsive therapy (ECT). But ECT is quite invasive, sending bolts of electricity through the skull and into the brain. With TMS, an electrical change occurs in the brain due to the magnetic field that occurs outside the skull. This is called electromagnetic induction and was discovered by Michael Faraday in 1831.

Photo by Michael Faraday
Michael Faraday discovered electromagnetic induction.
Welcome Collection/Wikimedia, CC BY

Over the next century, scientists and physicians such as Jacques-Arsn d’Arsonval and Sylvanus P. Thompson created devices that sought to artificially stimulate the nervous system, the former for a defibrillator and the latter to stimulate the brain. But they were so bulky and the amount of energy needed to produce the rapidly changing magnetic field that was needed made their development difficult.

It wasn’t until 1985 and the work of medical physicist Anthony Barker at Sheffield University led to the creation of a compact and relatively inexpensive device that allowed scientists to stimulate a 1cm area of ​​the brain at time intervals of their choosing. for fractions of a second. It is safe and is applied while the patient is awake.

The technique is used to treat depression and anxiety in two specific ways. Sending repetitive impulses into the brain at different frequencies can have different effects.

In depression, we know that activity is low in the left prefrontal cortex, the area of ​​the brain that is important in planning and thinking processes. So using a higher frequency pulse activates those neurons to help them work as they should, thereby easing symptoms of depression.

Conversely, the prefrontal area on the right side of the brain, known to be overactive in cases of anxiety, is treated with lower frequencies to calm the activity in that area.

Using this effect of changing the way neurons talk to each other (called neuroplasticity), it is hoped that with regular treatment, symptoms will be eased.

Treatment is given while the patient sits in a chair and feels something like a light tap on the skull.

Sure, but long-term results are needed

A review of TMS for the treatment of depression found conflicting evidence and called for long-term studies. But it’s clear there are benefits for people with refractory depression, and it’s safe in the elderly and pregnant women.

TMS is safe to give to those who lack metal, such as aneurysm coils, metal dental appliances or non-removable piercings in the head, or metal-containing pigments on the face. But it’s not recommended for people who have epilepsy.

The treatment has several advantages over ECT. With TMS, the patient does not need to be anesthetized; they have no seizures and no memory loss after treatment.

Using TMS in more clinics will give scientists more data to determine when it works and for whom, and which protocols are optimal. For example, TMS may have greater and longer-lasting benefits when paired with cognitive behavioral therapy (a type of talk therapy) as has been shown with antidepressants combined with CBT.

But it’s certainly a technique forged in the fire of cognitive neuroscience that can have a big effect on those desperate for help.

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