May 19, 2010
Mark George on rTMS Research and Treatment Resistant Depression
Time: 00:03:34 | Size: 3.30 MB
Speaker: Dr. Mark George
Description: NIMH Radio: Dr. Mark George of the Medical University of South Carolina talks about rTMS research and treatment resistant depression.
Announcer: NIMH radio… from Bethesda.
Dr. Mark George: Because depression is so common that's actually a very big number of people in America and around the world who have treatment resistant depression...and we struggle with appropriate therapies.
Announcer: Dr. Mark George, of the Medical University of South Carolina is a National Institute of Mental Health grantee and has been at the forefront of repetitive transcranial magnetic stimulation research - rTMS for short. Dr. George and his colleagues at three other institutions hope this recently completed study helps settle the debate on whether rTMS is effective on treatment resistant depression patients.
Dr. Mark George: This technology transcranial magnetic stimulation is a new technology where we take an electromagnet, place it on the scalp and turn it on and off and create an electrical current in the surface of the brain while people are awake and alert. So, we don't create a seizure and we do turn on a part of the brain for thirty or forty minutes a day.
Announcer: A common question asked of Dr. George is what does the electric current feel like...
Dr. Mark George: I usually- if you have a hard erasure on your desk and you tap yourself on the head with that most people say that's similar to what it feels like. So, it's uncomfortable but not terribly painful. Most people can tolerate it fine. Almost everybody says they wouldn't choose to do on purpose...it is unpleasant. However, when people say relative to the suffering that they have with their depression this was easily bearable and something they would chose to do.
Announcer: Data from this study shows 14-percent of depression patients treated with rtms achieved remission… or showed improvement in their condition. In comparison, 5-percent of those who received sham… or simulated treatment… reported improvement.
Dr. Mark George: Some people want to know- that 14-percent is kind of a small number and so, the question is...is this really clinically meaningful? And so there we have to compare it to what we're doing out in the real world. Unfortunately, we really have a real treatment gap with these people with this level of depression. And when we compare the results in this trial to what we're doing out there with medications with these people, it's at least as good as that, which is not very good unfortunately but it's at least as good...so that means it's probably clinically meaningful. Would we want it to be better? And the answer is absolutely yes. Do we have some clues about how to make it better? Yeah, but we need to do a lot more work to test whether those clues are right or not.
Announcer: Dr. George believes an important next step is to manipulate brain activity by combining RTMS with cognitive therapy.
Dr. Mark George: If we're really trying to influence this kind of governing cortical circuit why wouldn't we have somebody doing cognitive behavior therapy in the chair while we're stimulating. And so I think another way of potentially boosting TMS in the future might be to couple it with forms of behavioral or cognitive therapy that actually are working on the same circuits.
Announcer: Dr. Mark George of the Medical University of South Carolina...on NIMH radio.