Depression treatment reverses ‘reverse’ signals in the brain

Researchers at Stanford University found that certain brain signals are indeed misdirected in patients with treatment-resistant depression, and that magnets can correct the misdirection and make the patient feel better. I discovered that it can be done.

“This particular change in biology, the flow of signals between these two brain regions, is the first in psychiatry to predict changes in clinical symptoms,” said senior author of the paper detailing the findings. One Nolan Williams said.

Challenge: While most people living with depression can find some relief from their symptoms with medication, approximately 84 million people worldwide have treatment-resistant depression and have tried multiple antidepressants. means you don’t feel better.

However, about 50% of patients with treatment-resistant depression have do It responds to transcranial magnetic stimulation (TMS), according to Adam P. Stern, M.D., Ph.D., an assistant professor of psychiatry at Harvard Medical School, who was not involved in the new study. TMS uses magnetic fields to painlessly and non-invasively stimulate nerve cells in the brain, usually for 20 to 50 minutes a day, five days a week, for weeks or even months. To do.

“I was pretty skeptical, to be honest.”

Anish Mitra

This was a life-changing discovery for many people with stubborn depression, but exactly how it works has remained a mystery. This makes it difficult to know which patients are likely to benefit from TMS before they commit to treatment.

“A leading hypothesis is that TMS may alter the flow of neural activity in the brain,” said Anish Mitra, lead author of the new paper. “But to be honest, I was pretty skeptical.”

what’s new? To test his skepticism, Mitra and his colleagues recruited 33 people with treatment-resistant depression for this study, presented in PNAS.

Twenty-three of the participants received an accelerated and highly effective version of TMS known as “Stanford Neuromodulation Therapy.” The therapy consisted of 10 sessions per day for 5 days. Others received sham treatments.

All participants had their brain activity mapped using fMRI before and after the treatment phase of the study. Data were also collected on 85 people without depression.

In 75% of depressed patients, some of the signal flowed in the opposite direction.

result: When they analyzed fMRI data, they found a striking link between brain regions that control physical sensations (preinsular cortex) and emotions (anterior cingulate cortex).

As expected, signals traveled from the somatosensory area to the emotional area in the brains of non-depressed individuals.

“You can think of it as the anterior cingulate cortex receiving information about your body, such as your heart rate and temperature, and making decisions about how you feel based on all these signals,” Mitra explained.

Within 3 days after the end of TMS treatment, reverse signals were flowing in the correct direction.

However, in 75% of depressed patients, some of the signal runs in the opposite direction, and the more severe the depression, the higher the proportion of the signal in the opposite direction.

“It’s as if you’ve already decided how you feel and everything you feel is filtered through it,” says Mitra. “My mood has come first.”

Within 3 days after the end of TMS treatment, the reverse signals began to flow in the right direction and the patient reported an improvement in mood. The more severe the depression to begin with, the greater the reported improvement.

“Current technology approaches the complexity of the problems we are trying to understand.”

Mark Reichl

Conclusion: While not all patients with treatment-resistant depression showed signals in the wrong direction, the findings provide a useful indicator that the person has depression and is likely to respond to TMS. may become.

“Behavioral conditions such as depression have been difficult to image because, unlike obvious brain lesions, the relationships between different parts of the brain are subtle,” said lead author Mark Reichl. rice field.

“It is very encouraging that current technology is approaching the complexity of the problems we are trying to understand,” he continued.

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