This week, Bobbi Conner talks with Dr. Baron Short about the development of transcranial magnetic stimulation (TMS) & SAINT TMS to treat severe, treatment-resistant depression. Dr. Short is a Professor of Psychiatry and Medicine and the Medical Director of System Neuromodulation Services for MUSC.
TRANSCRIPT:
Conner: I'm Bobbi Conner for South Carolina Public Radio with Health Focus here at the radio studio for the Medical University of South Carolina in Charleston. About 30% of people with major depression do not respond to standard treatments like typical antidepressant medications and talk therapy. Doctor Baron Short is here to talk about a treatment approach for individuals with severe, treatment resistant depression. Doctor Short is a Professor of Psychiatry and Medicine and the Medical Director of System Neuromodulation Services for MUSC. Doctor Short, tell us about depression and treatment-resistant depression.
Dr. Short: Depression is a medical illness. It's not just sadness or a character flaw. This involves circuits in the brain that actually lose activity, and people lose their interest in things. They lose their pleasure. They can't sleep. They can't eat right, get incredibly sad. And when we talk about treatment-resistant depression, this is usually when people have tried at least two or more medications plus therapy, and they weren't really getting the help that they needed.
Conner: Give us an overview of the role that MUSC's research has played in the development of transcranial magnetic stimulation, or TMS, to treat severe depression.
Dr. Short: Sure. So, Charleston has been at the center of this from the beginning. Doctor Mark George, who works here at MUSC, had the original idea to put these magnetic waves or magnetic stimulation on mood circuits of the brain back in the mid 90s. And he actually led a large NIH funded trial that proved that TMS works for treatment of depression. And that led to FDA clearance, even insurance coverage. We've continued to do work with improving safety, the dosing, where to actually place the stimulation for optimal treatment. MUSC was also one of the first academic centers in the country to offer Saint TMS, not only as part of research, but as clinical treatment. And people are still doing that today.
Conner: Give us more details about this new version of TMS.
Dr. Short: So TMS itself is simple, involves magnetic pulses with a magnet placed on the head and activates the mood circuits of the brain. It doesn’t involve anesthesia and no sedation. And TMS is the next leap in that. And it involves three things: targeting, timing and dosing. The targeting involves actually getting an MRI where we take a video of the brain, and we use a computer over eight hours, to find the best spot to treat each individual. So, it's unique precision medicine.
Conner: Why is this considered an important breakthrough treatment for severe depression?
Dr. Short: Speed and size of effect are the two key breakthroughs in TMS. Instead of doing a treatment over 6 or 7 or 8 weeks, this is done over five days. In terms of size of effect, in the initial trials, 79% of people met criteria for remission of depression. That means they weren't just better, they were well. SAINT TMS is usually for adults with major depression who have tried at least two antidepressants in this episode of depression without getting well. We also think about people who need to get better, faster, someone who's severely ill, maybe recently in the hospital. We also think about people who can't come to treatment every day for six weeks, as in conventional TMS.
Conner: Dr. Short, thanks for talking with us about this treatment for treatment-resistant depression.
Dr. Short: You're welcome.
Conner: From the radio studio for the Medical University of South Carolina in Charleston, I'm Bobbi Conner for South Carolina Public Radio.
Health Focus transcripts are intended to accurately represent the original audio version of the program; however, some discrepancies or inaccuracies may exist. The audio format serves as the official record of Health Focus programming.
