January 18th 2024
Novel MRI technique could help patients with depression
A major new trial that used MRI neuronavigated Transcranial Magnetic Simulation (TMS) to help people who have been struggling with depression.
The results of the trial, which were published on 16th January, discovered that symptoms eased in patients for at least six months. Five centres across England were involved in the trial including, Nottingham, Camden and Islington, Newcastle, Northampton, and Oldham.
Funded by the Medical Research Council and the National Institute for Health and Care Research, the trial, which involved 255 participants, uncovered that over two-thirds responded to treatment, with a further third showing 50% improvement and a fifth managing to move into remission and stay there.
Professor Richard Morris, lead for the Centre for Mood Disorders at the Institute of Mental Health at the University of Nottingham, said: ‘Given these patients are people who have not responded to four previous treatment attempts and have been ill for an average of seven years, to get such a significant response rate and a fifth who have a sustained response is really encouraging.’
‘Patients who responded to the treatment could stay relatively well compared to how they were previously, with as little as one or two treatments a year,’ Professor Morris said. ‘The changes we saw were substantial, not only in reducing their depression symptoms, but they were large enough to improve concentration, memory, anxiety and subsequently their quality of life.’
Used since the 1980s, TMS is an outpatient treatment which involves people getting powerful magnetic pulses delivered to the left side of their head. The person is conscious and has 20 sessions over a four-to-six-week period. This method has previously been used to treat people with depression as it targets the area of the brain where stimulation is thought to be helpful, however there is now more evidence to showcase its benefits.
Against this backdrop, one of the reasons this trial was conducted is due to the number of people tragically taking their own life as a result of depression. Recent data from the World Health Organisation (WHO) claimed that suicide from depression is the biggest killer in people aged between 15 and 49.
Speaking about how the trial was conducted, Professor Morris said: ‘Ideally when people come for a TMS session, they would sit in the exact same place, but this is rarely going to happen. This method uses light from both ear lobes and the top of the nose to measure the stimulation point from the first time a patient has the treatment.
‘The MRI personalises the site of stimulation and then neuronavigation makes sure the same site is being stimulated at each treatment session. This reduces the variability in stimulation at each session.
‘Since the magnetic pulse can be focused, there are usually only minor short-lasting side-effects, and the person can return to their daily activities immediately on return from the hospital.’
Image: Bret Kavanaugh
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