What is Therapeutic Neuromodulation?
Neurons in the brain function as networks connected both electrically and electrochemically. Brain function can be altered in disease states due to disturbed neural function, faulty conduction, or faulty function of brain networks. The therapeutic alteration or modification of brain activity using magnetic or electrical energy is called neuromodulation. Neuromodulation techniques can be non-invasive, examples include Transcranial Magnetic Stimulation (TMS), Electroconvulsive Therapy (ECT), and Transcranial Direct Current Stimulation (TDCS).
Transcranial Magnetic Stimulation
Transcranial Magnetic Stimulation is a non-invasive, FDA approved treatment option for patients with major depressive disorder or obsessive-compulsive disorder. It is an effective and proven treatment and can help many patients who have not benefitted from prescription medication or psychotherapy treatments.
TMS has also been shown to beneficially alter neurotransmission in other brain areas involved in several disorders, including anxiety, and insomnia. TMS is an effective, non-invasive, outpatient therapy and is appropriate for adults with depression, who have failed to achieve satisfactory improvement from prior antidepressant medications.
The UMass Center for Neuromodulation is the only center of its kind in New England that brings the specialties of Neurology, Psychiatry, Neurosurgery, Psychology and others under one roof for patient care. It also brings expertise from cutting edge research from bench to bedside. We tailor TMS for the patient’s symptom profile and comfort and offer a symptom- tailored treatment that includes both deep TMS and r-TMS.
- Transcranial magnetic stimulation involves highly specific neuronal stimulation using a series of repetitive electromagnetic fields to create electrical changes in mood regulating areas in the prefrontal cortex.
- r-TMS: High frequency repetitive transcranial magnetic stimulation (r-TMS) applied to the left dorsolateral prefrontal cortex has been shown to relieve depression. r-TMS causes focal neuronal changes and produces no cognitive side effects.
- Deep TMS: Deep transcranial magnetic stimulation (d-TMS) is Transcranial magnetic stimulation that penetrates deeper than other superficial repetitive (r-TMS) devices.
- t-DCS: Transcranial Direct Current Stimulation is a non-invasive brain stimulation technique that applies a small (1-2 mA) direct current via scalp to enhance or diminish neuronal excitability in a specific brain area. T-DCS has been shown to be effective in many psychiatric disorders. It has also been shown to alleviate cognitive and depressive symptoms in preliminary clinical studies. t-DCS can be a safe, easy to administer, office-based, inexpensive and effective treatment option.
Electroconvulsive therapy (ECT) is one of the treatment options for patients with severe depression, catatonia, psychotic depression, mania and refractory schizophrenia. It is one of the most safe and effective treatments for depression and can save lives when other treatments have failed.
ECT is usually offered to patients with depression who have not responded to medications; have had excessive side effects from medication; or require rapid response due to serious medical risks. More than 80 percent of patients respond to ECT. It is well tolerated and produces more rapid relief than most other treatments. Most patients treated with ECT respond well, tolerate it well, and get relief from their symptoms. Some patients develop memory problems during the acute series of treatments. These problems gradually improve after treatment is completed.
- Technique of ECT: During electroconvulsive therapy, the patient is anesthetized, and a small amount of electrical current is used to stimulate the brain. This produces a modified seizure, which, in turn, changes the activity of the brain regions involved in depression. Some of these changes are similar to those seen with antidepressant medications. The medications used for anesthesia cause sedation and prevent injury so that patients feel no discomfort during the procedure.
Contact your primary care physician for a referral to the Center or call us at (508) 334-1055.
- National Institutes of Mental Health- https://www.nimh.nih.gov/health/topics/depression
- National Network of Depression Centers- https://www.nndc.org
- Katherine Kitty Dukakis on ECT: By Katherine Kitty Dukakis
- 60 Minutes: Is Shock Therapy Making a Comeback?: Watch a segment on electroconvulsive therapy (ECT) featuring McLean’s Charles Welch, MD, and Kitty Dukakis, wife of former Massachusetts governor Michael Dukakis.