Investigating how the brain changes during depression treatment

Investigating how the brain changes during depression treatment
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Researchers have demonstrated brain changes when a person receives a depression treatment called repetitive transcranial magnetic stimulation (rTMS).

Typically, rTMS is employed when other depression treatments such as medications are ineffective. Estimations show approximately 40% of people with major depression do not respond to antidepressants.

An rTMS session involves an electromagnetic coil placed against a patient’s scalp. The device painlessly delivers a magnetic pulse that stimulates nerve cells in the brain region involved in mood control called the dorsolateral prefrontal cortex.

The researchers explored how this depression treatment changed the brain and published their findings in the American Journal of Psychiatry.

How the brain changes during depression treatment

“When we first started this research, the question we were asking was very simple: we wanted to know what happens to the brain when rTMS treatment is being delivered,” said Dr Fidel Vila-Rodriguez, an assistant professor in UBC’s department of psychiatry and researcher at the Djavad Mowafaghian Centre for Brain Health (DMCBH).

To gather their data, the team delivered one rTMS session to patients whilst using magnetic resonance imaging (MRI) to monitor their brain activity. They were able to illuminate real-time changes occurring in the brain.

rTMS treatment: fewer symptoms recorded

By stimulating the dorsolateral prefrontal cortex, other brain regions were activated during this process. These other regions are involved in multiple functions — from managing emotional responses to memory and motor control.

The study’s participants underwent a further four weeks of rTMS depression treatment, and the team assessed whether the activated regions were associated with patients having fewer symptoms of depression.

“We found that regions of the brain that were activated during the concurrent rTMS-fMRI were significantly related to good outcomes,” said Dr Vila-Rodriguez.

A greater understanding of the brain region changes during rTMS could lead to establishing whether a patient responds to this depression treatment.

“By demonstrating this principle and identifying regions of the brain that are activated by rTMS, we can now try to understand whether this pattern can be used as a biomarker,” he said.

Following this discovery, Dr Vila-Rodriguez is investigating how rTMS can be used to treat a range of neuropsychiatric disorders, specifically Alzheimer’s disease.

Dr Vila-Rodriguez said: “this type of research will hopefully encourage more widespread adoption and accessibility of rTMS treatments across the country. Despite being approved by Health Canada 20 years ago, rTMS is still not widely available. In British Columbia, there are some private clinics that offer rTMS, but it is not covered by the provincial health plan.”


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