Shock Therapy Takes on a New Form
Lisanby says research is progressing on using transcranial magnetic stimulation that works without producing a seizure -- but adds that there is a group of depressed patients that will need to have a seizure in order to get better. "I hope we get to the point where [transcranial magnetic stimulation without a seizure] will be useful, but it doesn't help all patients," she says.
Lisanby explains that both ECT and transcranial magnetic stimulation produce electricity in the brain, which stimulates brain cells. "The major difference is how you get the electricity to the brain," she tells WebMD. "With ECT [it goes] through the scalp and skull, which causes the energy to be smeared because the scalp and skull act as resistors."
The scattering of energy throughout the scalp, skull, and brain with ECT produces a host of unintended side effects, including amnesia. With MST, in contrast, energy is passed through the scalp and skull as if they were transparent, and can be targeted to specific areas of the brain. "The goal is to peel away the unintended effects by developing a more refined treatment," Lisanby says.
She cautions that transcranial magnetic stimulation, with or without a seizure, requires much more work before it will be available as a treatment. But, she says, "It is exciting the way the field has been evolving on all fronts," she says.
Mark George, MD, hails the study as an important extension of research on the new technology of transcranial magnetic stimulation.
"It shows they can reliably induce a seizure and that the side effects are less," says George, professor of psychiatry, radiology, and neurology at the Medical University of South Carolina, in Charleston. " It's important work."
George believes that transcranial magnetic stimulation -- whether it is used to induce a seizure or not -- is bound to be superior to ECT. "You are much more efficient with your energy delivery with [transcranial magnetic stimulation], instead of spreading it around the skull as with ECT," he tells WebMD. "What remains to be explored is whether it works to treat depression, and if so in whom."
Ultimately, the question researchers need to answer is where in the brain to focus the stimulation, he says.
But like Lisanby, George believes that the new technology can be used without causing a seizure, and that inducing a seizure is not necessary to treat depression. He says that there is a "widespread assumption" that you need to cause the person to have a seizure. "I think there are ways of getting depressed people undepressed without inducing a seizure."