Magnetic Pulses Zap Migraine Pain

BOSTON, June 27 -- For patients who get migraine with aura, a hand-held magnetic device about the size and shape of a hairdryer can zap the pain before it starts, a researcher said here.

Used at the aura stage, the transcranial magnetic stimulation device was nearly twice as likely as a sham treatment to reduce the incidence of a full migraine headache, according to Yousef Mohammad, M.D., of Ohio State University Medical Center in Columbus.

The industry-sponsored phase III randomized double-blind trial follows earlier research that showed the magnetic stimulation process was effective when used in a hospital setting, Dr. Mohammad told attendees at the American Headache Society meeting.

Dr. Mohammad said the device -- which sends two one-Tesla magnetic pulses into the back of the head -- is also safe, with no serious adverse events attributed to it.

"It feels like a slight pressure at the back of the head and that's it," he said.

The theory is that the magnetic pulses interrupt a process called cortical spreading depression, now thought to be the underlying mechanism for migraine with aura, he said.

A similar technique is being tested in patients with depression.

For this study, patients were randomized to a device that emitted the magnetic pulses or to a sham machine. They were told to use the device when the migraine aura began and to record their pain intensity and symptoms at time of treatment and again 30 minutes, one hour, two hours, 24 hours, and 48 hours later.

The intent-to-treat population of 164 patients had a mean age of 39 and 79% were women. Most patients treated themselves while still pain-free or with mild pain (31% and 40%, respectively) but 23% had moderate pain and 6% said their pain was already severe before they used the machine.

The primary endpoint of the study was absence of pain at the two-hour mark, Dr. Mohammad said, where 39% of the active treatment group had no pain, compared with 20% of those using the sham machine.

The difference was significant at P<0.018, he said.

Rates of symptoms such as nausea, photophobia, and phonophobia in the active treatment group were equal to or lower than those seen in the group using the sham machine, according to Dr. Mohammad.

Because of the lack of adverse events and the previously established safety of the transcranial magnetic stimulation device, he said, "this is a promising treatment for migraines with aura."

He added that it also sets the stage for research in migraines without aura.

The device is not yet approved by the FDA, Dr. Mohammad said, but the okay could come within the next six months, based on the current trial.

He added that medical treatments for migraine with aura work in only about half of all patients and some of those can't tolerate the drugs. "There is a definite need for alternatives," Dr. Mohammad said.

The study was supported by NeuraLieve Inc., of Sunnyvale, Ca., manufacturer of the device. Dr. Mohammad serves on the company's medical advisory board

Primary source: AHS Meeting

Secondary Source: medpageTODAY®
Source reference:
Lipton RB, et al “Transcranial Magnetic Stimulation (TMS) using a portable device is effective for the acute treatment of migraine with aura: Results of a double-blind, sham controlled, randomized study” AHS Meeting 2008; LB abstract 450026.

St. Jude gets depression study under way

CHICAGO, June 26 (Reuters) - St. Jude Medical Inc (STJ.N: Quote, Profile, Research) said on Thursday that the first two patients had received its pacemaker-like implant as part of a clinical study to determine whether deep-brain stimulation will help people with severe depression.

A 59-year-old woman and a 42-year-old man were implanted with the St. Jude Medical Libra Deep Brain Stimulation System, an investigational device, at Alexian Brothers Behavioral Health Hospital in Chicago, the company said.

The stopwatch-sized device is implanted in the chest, with leads that send electrical impulses to specific parts of the brain thought to be involved in depression.

St. Jude's study is researching a specific area in the brain called Brodmann Area 25 that is thought to play a role in depression. Brain imaging studies indicate that Brodmann Area 25 appears to be overactive in severely depressed people.

Medtronic Inc (MDT.N: Quote, Profile, Research) is also investigating whether its device, commonly known as a "brain pacemaker," can help severely depressed patients.

The National Institute of Mental Health estimates that more than 21 million U.S. adults suffer from some kind of depressive disorder. Current therapies are effective for about 80 percent of this patient population, according to the National Advisory Mental Health Council, leaving about 4 million adults who do not respond to medication, psychotherapy or electroconvulsive therapy.

Shares of St. Jude, which also makes cardiac pacemakers and implantable cardioverter defibrillators, were down 83 cents, or 2 percent, at $40.42 at midday amid a weaker broad market. (Reporting by Debra Sherman; Editing by Maureen Bavdek)

TMS Treatment Program at UPenn

John P.O'Reardon and colleagues describe their TMS Treatment program on this site.

You can contact them here.

Job Offer - Ph.D Scholarship in Neuroscience - Neuroplasticity and TMS

Ph.D Scholarship in Neuroscience - Neuroplasticity and TMS

School of Psychiatry, University of New South Wales, Sydney, Australia

The School of Psychiatry at UNSW invites applications for a Ph.D. Scholarship investigating mechanisms of Neuroplasticity, to commence in the 2nd half of 2008. Each scholarship is for $27,500 p.a. for a maximum of 3 years,

The Scholarship will focus on the use of transcranial magnetic stimulation (TMS) and other techniques to investigate mechanisms of neuroplasticity in health, ageing and psychiatric disorders. This scholarship is offered as part of the Brain and Ageing Program, UNSW, a high profile research program funded by the NH&MRC, which aims to evaluate the determinants of age-related cognitive disorders. The successful doctoral student will be working with Professors Colleen Loo and Perminder Sachdev, researchers with a track record in brain stimulation techniques, in conjunction with neurophysiology collaborators, based in Randwick, Sydney.

Applicants are encouraged from students/researchers from a variety of backgrounds, including but not limited to medicine, psychology, neurophysiology and neurology.

For further details, please contact Assoc. Prof Colleen Loo (by phone +61-2-9113 2039, or email.

Brainsway reports interim results for bi-polar treatment

Participants in the study had not responded to previous drug treatments.
Globes correspondent 5 Jun 08 16:39
Medical device company Brainsway Ltd. (TASE:BRIN) has reported the interim results of the trial of its Deep Transcranial Magnetic Stimulation (TMS) device in the treatment of bio-polar disorder (manic depressive) patients at the Shalvata psychiatric hospital who did not respond to other treatments.
The results showed a satisfactory response among patients who had previously been treated with antidepressants, and who did not report any side effects during the trial. 80% of the patients responded to treatment, with more than 50% reporting a significant improvement, using the various depression measurement scales.

Our fellow weblog Brain Stimulant has an interesting comment on these results.

Neural Stimulation Successfully Treats Depression in Patients With Prior Ablative Cingulotomy

A clinical case conference in the American Journal of Psychiatry by Nejmat et al.

From the abstract:

In this article, we describe the case of a patient who, under the direction of a multidisciplinary case committee, underwent both an ablative cingulotomy and subsequent bilateral deep brain stimulation placement in the Cg25 area. Review of this case provides a means of comparing the two techniques and of illustrating what we feel are some important advantages to using stimulation in the treatment of major depression. This report also provides potential insight into common and unique mechanisms mediating the two procedures.