By: The Staff at MHCD Issue: Vision Section: Collaboration Close Up What looks like an ordinary dental chair, upon closer inspection, is the latest technology in transcranial magnetic stimulation, most commonly referred to simply as (TMS) has arrived in Denver. This revolutionizing technology located at the Mental Health Center of Denver’s (MHCD) Center for TMS Therapy, is the first community mental health center in the country to offer TMS therapy. “MHCD is recognized as the national center of excellence in mental health treatment,” said, Tom Base, Director of Business Development, who helped bring TMS to MHCD. “TMS allows us to remain on the forefront of innovative treatments and technologies.”
The Economic Burden of a Neurological Disorder
Depression affects at least 18 million American adults each year, or more than 7 percent of the adult population. In 2000, the economic burden of depression was estimated at $83.1 billion in the U.S. A recent study sponsored by the World Health Organization and the World Bank found unipolar major depression to be the leading cause of disability in the United States.
While TMS technology has been around for over 25 years, residing mostly in academic and research settings, it has not been until recently that physicians have begun to explore the therapeutic potential of TMS for the treatment of a variety of diseases—with depression being the most thoroughly studied to date. Since the late 1990s, more than 30 randomized, controlled trials have been published, and collectively demonstrate the safety and effectiveness of TMS for the treatment of depression. The FDA cleared TMS therapy to market in late 2008, with the first commercial TMS machines for clinical use only now being delivered.
TMS uses a magnetic field that generates similar power to that of MRI machines found in a doctor’s offices or imaging centers. Rather than creating an image, the TMS device generates a magnetic pulse that penetrates two-to-three centimeters into the brain, stimulating the region of the brain called the left dorsolateral prefrontal cortex, which is thought to be involved with mood regulation and is often underactive in those suffering with depression. TMS is thought to facilitate the release of neurotransmitters, namely serotonin, norepinephrine and dopamine that play a role in depression and to increase blood flow to the area. TMS may also promote the formation of new connections, called synapses, between neurons, with consequent remodeling of the brain.
No Medication/No Side Effects
TMS therapy is a non-invasive medical treatment that patients receive right in the doctor’s office. It is available by prescription and delivered under the supervision of a psychiatrist. It is a 37-minute outpatient procedure administered daily for four to six weeks. During the therapy session, the patient is wide-awake in a comfortable chair. The small treatment magnet, about the size of a cupped hand, rests on their head, delivering focused magnetic stimulation. Since there is no sedation involved, patients are able to drive themselves safely home or to work immediately following the session. There are no known side effects associated with TMS therapy other than some possible mild discomfort at the treatments site on the scalp. And, because there are no systemic medications involved, TMS does not interact with other drugs or cause the side effects normally associated with antidepressant medications such as weight gain and sexual dysfunction. TMS may be a good alternative to traditional medications for pregnant and lactating women.
The Future of Neurobiology
While TMS is currently only approved for major unipolar depression, it has shown promise in other psychiatric and neurological diagnoses. Currently, TMS is under clinical trials for Parkinson disease, Alzheimer’s disease, fibromyalgia, schizophrenia, stroke rehabilitation, Post-Traumatic Stress Disorder, tinnitus and many other conditions. Dr. Peter Wagner, one of the lead physicians at the Center for TMS Therapy at the Mental Health Center of Denver and one of the few certified neuropsychiatrists in the state of Colorado, he is particularly interested in the future of TMS. “We are now able to directly and narrowly target and treat the affected area of the brain associated with a particular disease, in this case, depression. In the future, current and next generation TMS technologies may offer a completely different paradigm in how we treat a wide range of brain illnesses,” he said. Thousands of patients across the country have been responding positively to TMS therapy. As one TMS patient recently said, “I’m not looking to be ‘antidepressed.’ I want my life back; TMS is the first treatment that offered me that.”
For more information about TMS therapy at the Center for TMS Therapy at the Mental Health Center of Denver, go to www.tmsmhcd.org.