News Story

Friday, November 20, 2009
Neuro-Procedure Succeeds in Treating Depression

Doctors at Walter Reed Army Medical Center are using an electrical stimulation device that looks like a high-tech dentist’s chair to successfully treat some of their patients with depression. Doctors around the world are following the research on the pioneering medical treatment to determine its full potential.

Lt. Col. Geoffrey Grammer, M.D., chief of inpatient psychiatry at Walter Reed Army Medical Center, demonstrates the rTMS system.The device, called a repetitive Transcranial Magnetic Stimulation (rTMS) system, utilizes a phenomenon known as electromagnetic induction – the rapid changing of magnetic fields – to create small electric currents that essentially jump-start the brain.
 
Magnetic pulses are aimed at the prefrontal cortex of a patient’s brain, where mood regulation is controlled, at rates faster than one pulse per second. As these pulses penetrate brain tissue, they create electric currents that excite neurons and ultimately stimulate nerve cells to trigger brain activity.
 
Lt. Col. Geoffrey Grammer, M.D., who is chief of inpatient psychiatry at Walter Reed, said rTMS offers him a new line of treatment for some of his patients with the worst cases of depression.
 
“TMS offers hope to the men and women in the armed forces who have tried a multitude of treatment options with little success,” Grammer said. “It’s not a cure-all, but for the patients that it works on, it’s simply amazing.”
 
Grammer said that 24 patients have been treated with TMS at Walter Reed so far, and that 500 TMS procedures have taken place.
 
A New Kind of Therapy
 
Grammer says that when successful, the results can be astounding.
 
“I watched one patient go through the process from beginning to end,” Grammer said. “By the time she completed therapy she literally began looking and acting like a new woman.”
 
Although many patients see phenomenal results, about half require a follow-up phase within six months of the therapy. If symptoms return, Grammer will offer a three-week “maintenance phase.”
 
TMS therapy was originally developed, tested and cleared by the U.S. Food and Drug Administration in 2008 to treat depression, but Grammer thinks there are other applications for the technology. He is currently compiling a team of researchers to develop new uses for the system and continue his research on the therapy, which is not widely available in hospitals.
 
For example, Grammer thinks the treatment could also be used to “exercise the brain” of traumatic brain injury patients, much in the same way physical therapists exercise damaged limbs.
 
He also believes the stimulation could have applications for post-traumatic stress disorder patients and service members with post-amputee pain syndrome. The potential benefits, he speculates, could forever change the way mental health issues in the military and the civilian sectors are addressed.
 
While other applications are in the process of being developed, there are many service members who might greatly benefit from getting rTMS treatment now, according to Grammer.
 
With practically no side effects, no risk of long-term health concerns and high efficacy ratings, rTMS could potentially extinguish the remaining barriers that inhibit service members from seeking mental health treatment, Grammer said.
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Comments (4)
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MAJ Nicole Doyle at 2009-11-20 21:53:41 wrote:

Sounds promising! Will procedure eventually be considered as an extension of the biofeedback aspect of mental health treatment? Are you or someone considering pre and post assessments to track results? I look forward to reading more about the treatment and follow-up information. Thanks for taking the leap of faith!
Timoth Mulkey at 2009-12-11 21:39:52 wrote:

I have researched the effects of Nerufeedback and have sought to use it myself. The applications go far beyond depression, phantom limb pain, and the areas mentioned in this article. My research has also found that one company that advertises a product called "Play Attention" can't compare to in person care. Many insurance companies have not covered this type of care; if it is to be covered it will be years until it is accepted widely and paid for by medical insurance carriers. At seventy dollars per session, I am willing to pay for the relief from pain and the medications to treat other service connected disabilities. I pose this question to Tricare and the Veterans Administration. "With such remarkable results on a high percentage of candidates, why is it easier for medication to be prescribed with so many adverse results? Comparing medication to biofeedback (nerufeedback), medications have a higher percentage of adverse side effects?" Soldiers, veterans have to wait longer for cutting edge care. Medical care that civilians have immediate access to. Why the wait, and why the refusal to accept a new way of caring for soldiers and veterans?
Andrew at 2009-12-13 20:52:13 wrote:

I suffer from depression. It has been 6 years or so and I take anti depressant medication. Medication which allows me some sleep, although insomnia and anxiety still are issues I deal with. I am wishing I could be treated in this process, my depression is such an energy zapper. I try to contribute but it has not been easy. My whole life changed with depression. I have difficulty dealing with the demands that I do deal with, given the low amount of energy I have to deal with them. God Bless you for helping the people that you are. I know what depression is and I know it's not an appealing life sometimes which I deal with.
Lt Col Matt Tyykila at 2009-12-14 15:12:15 wrote:

This same device has been shown in European studies to successfully treat tinnitus. With a lot of military members suffering from this frustrating malady, myself included, I'd like to see the DoD look into duplicating those studies and hopefully implementing this as a treatment protocol.
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