NIMH Center to Study DBS in OCD created at the University of Rochester Medical Center

Rochester will serve as the hub of a five-year collaborative effort that includes six institutions around the nation and in Puerto Rico. The Silvio O. Conte Center will link more than 50 researchers who will focus on how deep brain stimulation affects people with obsessive-compulsive disorder. Read more about it here.

Antidepressant efficacy of high-frequency transcranial magnetic stimulation over the left dorsolateral prefrontal cortex in double-blind sham-controll

PMID: 18447962
TITLE: Antidepressant efficacy of high-frequency transcranial magnetic stimulation over the left dorsolateral prefrontal cortex in double-blind sham-controlled designs: a meta-analysis.
AUTHORS: D J L G Schutter
AFFILIATION: Experimental Psychology, Utrecht University, Utrecht, The Netherlands. d.schutter@uu.nl
REFERENCE: Psychol Med 2009 Jan 39(1):65-75
BACKGROUND: For more than a decade high-frequency repetitive
transcranial magnetic stimulation (rTMS) has been applied to the left
dorsolateral prefrontal cortex (DLPFC) in search of an alternative
treatment for depression. The aim of this study was to provide an update
on its clinical efficacy by performing a meta-analysis involving double
-blind sham-controlled studies. METHOD: A literature search was
conducted in the databases PubMed and Web of Science in the period
between January 1980 and November 2007 with the search terms 'depression
' and 'transcranial magnetic stimulation'. Thirty double-blind sham-
controlled parallel studies with 1164 patients comparing the percentage
change in depression scores from baseline to endpoint of active versus
sham treatment were included. A random effects meta-analysis was
performed to investigate the clinical efficacy of fast-frequency rTMS
over the left DLPFC in depression. RESULTS: The test for heterogeneity
was not significant (QT=30.46, p=0.39). A significant overall weighted
mean effect size, d=0.39 [95% confidence interval (CI) 0.25-0.54], for
active treatment was observed (z=6.52, p<0.0001). Medication
resistance and intensity of rTMS did not play a role in the effect size
CONCLUSIONS: These findings show that high-frequency rTMS over the
left DLPFC is superior to sham in the treatment of depression. The
effect size is robust and comparable to at least a subset of
commercially available antidepressant drug agents. Current limitations
and future prospects are discussed.

US Study Of Deep Brain Stimulation For Obsessive-Compulsive Disorder?

Butler Hospital in Providence, R.I., is leading a clinical study evaluating the effectiveness and safety of deep brain stimulation (DBS) for severe obsessive-compulsive disorder (OCD). Benjamin D. Greenberg, MD, PhD, associate professor of psychiatry at Butler Hospital and the Alpert Medical School of Brown University, is the lead investigator. He noted, "In the most severe cases, OCD causes profound impairment in work and social life, as well as tremendous suffering. Our work, plus that of colleagues in Europe, shows that DBS is a promising treatment for patients with OCD who remain very ill and debilitated despite the best available standard treatments, which are cognitive behavioral therapy and medications."

In DBS, thin wires are implanted in brain circuits that are involved in OCD. The wires are connected under the skin to a battery-powered stimulating device, which is implanted in the patient's chest. These are the same kinds of devices that have become an FDA-approved standard of care for people with Parkinson's disease and other movement disorders. Pilot studies at Butler's OCD Research Clinic, Massachusetts General Hospital, and the other centers that are part of this trial have found that stimulation in this area reduced OCD symptoms.

According to the World Health Organization, OCD is one of the most disabling medical conditions. DBS offers people who have not been helped by specific behavior therapy for OCD and medications another potential treatment option.

The U.S. Food and Drug Administration has approved DBS for humanitarian use for patients with OCD. The study is working closely with other scientists and physicians who were just awarded funding by the National Institute of Mental Health to establish the Silvio O. Conte Center to carry out research to understand more about DBS in OCD. Suzanne Haber, PhD, heads this center at the University of Rochester Medical Center, and Dr. Greenberg at Butler Hospital and Brown University is its co-director.

Dr. Greenberg says that there is also a companion study of brain functioning in OCD that does not involve surgery.

Source: Butler Hospital

Pico-Tesla Starts Phase III Clinical Trial of Its Proprietary Magnetic (Magneceutical) Therapy for Parkinson`s Disease

This sounds interesting, I at least never heard of this "Pico-Tesla" technology. Read the Press Release here, and a blurb about the method:

Magneceutical Therapy involves the use of an extremely low-level electromagnetic field (EMF) applied by a specially designed device-the Resonator, invented by Dr. Jerry I. Jacobson, along with proprietary therapeutic protocols-intended to improve a number of the signs and symptoms of Parkinson`s and other neurological-based diseases.

Using Deep Brain Stimulation on the Mind: Handle with Care

A great article by Mahlon R. DeLong on DBS in the DANA Foundation Magazine.

The abstract:

Deep brain stimulation has worked for many patients with Parkinson’s disease and other movement disorders that have not responded to other treatments. However, its use as a therapy for psychiatric disorders, while promising, is not yet proven. Mahlon DeLong, a pioneer in the use of deep brain stimulation, explains the technique and why its use for depression, obsessive-compulsive disorder and other psychiatric problems requires extra caution.

Deep Brain Stimulation for Severe Alcoholism

The Neurocritic Blog writes somewhat critically about data recently published on the use of DBS for the treatment of Alcoholism He cites a recent paper on ethical issues of dbs in psychiatry. Very interesting, read it here.

Deep Transcranial Magnetic Stimulation Gets European Regulatory Approval for Treatment of Depression

Brainsway, a firm building transcranial magnetic stimulation systems (TMS) out of Jerusalem, Israel, just received European approval to market its devices for the treatment of depression. The TMS treatment is likely to be used initially for cases of severe drug resistant depression. But we can envision a day when this technology becomes a mainstream therapeutic option for bipolar disorder and some other psychiatric diseases.

About the technology from Brainsway:

Transcranial magnetic stimulation (TMS) is a noninvasive technique used to apply brief magnetic pulses to the brain. The pulses are administered by passing high currents through an electromagnetic coil placed adjacent to a patient's scalp. The pulses induce an electric field in the underlying brain tissue. When the induced field is above a certain threshold, and is directed in an appropriate orientation relative the brain's neuronal pathways, localized axonal depolarizations are produced, thus activating the neurons in the relevant brain structure.
Standard TMS coils are limited to activation of only cortical brain regions, up to a depth of about 1.5 cm. Hence when treating depression with a standard TMS system, the limbic system, which is related to mood regulation and is generally deeper than 1.5 cm, is only indirectly affected, through secondary processes involving cortical structures, which are directly activated by TMS and then affect the deeper limbic system structures.