The field of placebo response with the use of devices as treatment for major depression is hardly researched. Herb one of my very much appreciated readers and commenter asked me about the evidence on the placebo response to devices for major depression, didn't have an answer. Tried searching but to no effect until recent. A lot of devices such as treatment with Transcranial Magnetic Stimulation (rTMS), Vagus Nerve Stimulation (VNS) and transcranial direct current stimulation (tDCS) are under study for the treatment of depression, mostly treatment resistant depression. Two recent meta-analyzes showed that placebo effect plays a significant role in clinical .....read more »

Efficacy of rTMS for treatment resistant depression isn't impressive to say the least. The results of studies show little clinical relevance of the efficacy compared to sham rTMS, many studies have reported limited effect sizes or response rates. A recent study tried to address one of the main concerns that could be responsible for the lack of efficacy namely the way in which the rTMS treatment is targeted over the Dorsolateral Prefrontal Cortex (DLPFC). The localization is done with "the 5 cm measure", this involves the localization of the motor cortical site for optimal stimulation of a hand muscle, usually the abductor .....read more »

This is a dutch video on TMS used in a prior post on this blog: Look what TMS can do in the hand of a smart dutch psychologist. Jan Martens is the author of Medblog.nl. He is conducting a historical research about the use of electricity and magnetism in psychiatry. He is now focussing on Transcranial Magnetic Stimulation (TMS). He is looking for some old videos about TMS. In this recent post he collected several more recent videos on TMS. He is looking for old videos on this subject, can anyone help him out? This morning I was looking at some .....read more »

Two blogs announced the news that the FDA had approved rTMS for depression. Therapeutic Neuromodulation Finally, 3 years after the first presentation of the trial data at the 2005 ACT meeting and one year after the publication of the results in Biological Psychiatry by Jonny O'Reardon the manufacturer Neuronetics got the treatment approved by the FDA for the treatment of depression... Brain Stimulant has an excellent introduction about the history of rTMS with links to the press release. My opinion on rTMS in depression has been discussed in several posts on this blog. Had to update some of the information regularly. You can read .....read more »

On this blog a lot of posts are about rapid Transcranial Magnetic Stimulation (rTMS), in short Dr Shock is not convinced that rTMS is effective in depression. On Therapeutic Modulation there is an abstract of a recent published study in the Journal of Affective Disorders about the cost effectiveness of rTMS versus electroconvulsive therapy (ECT). Their conclusion: Informal care costs were higher for the rTMS group. Total treatment, service and informal care costs were also higher for the rTMS group. The cost-effectiveness acceptability curves indicated a very small probability that decision-makers would view rTMS as more cost-effective than ECT. Related posts:Grand Rounds 5.47 .....read more »

rTMS is using electromagnetic fields to influence the brain,on this video you can see magnetic fields although not related to rTMS. The comment is very technical but the video is amazing, even scary.From: Environmental graffitiCombining their scientific experience with artistic instinct in sound, animation and programming they have created a ‘magnetic magnum opus’ - a ‘tour de force’ of immense invisible force brought down to human scale. And it is precisely the meeting of scale that makes the work so fascinating - to think that these tiny pulsating currents surround our planet on a scale inconceivable to man is not .....read more »

Columbia University Medical Center has used conventional transcranial magnetic stimulation (TMS) to reduce the deficits in working memory associated with sleep deprivation.On Brain StimulantrTMS can do other things as well, read about 8 Effects of TMS on Brain Function but how does TMS work? Related posts:The placebo response of transcranial magnetic stimulation The field of placebo response with the use of... Squirrel Memory Test This entry for NewScientist proves that squirrels don’t smell... Insomnia and Depression patients with depression often complain of difficulty getting to... Related posts brought to you by Yet Another Related Posts Plugin. ..read more »

Rapid Transcranial Magnetic Stimulation (rTMS) to the left prefrontal cortex is not more effective than sham rTMS for depression. This was the result of a recent published randomized controlled trial with 4 month follow-up.rTMS is a non-invasive method to stimulate the brain. Weak electric currents are induced in the cortex of the brain by rapidly changing magnetic fields (electromagnetic induction). This way, brain activity can be triggered with minimal discomfort, no need for anesthesia, and no cognitive side-effects. Side effects of rTMS are: discomfort or pain from the stimulation of the scalp and associated nerves and muscles on the overlying .....read more »

Another open labeled trial with rTMS. It is a continuation trial after a recent double-blind placebo controlled trial with rTMS.This study is discussed in a recent post on this blog: Finally some good news about rTMS?Considering the outcome on the time point at week 4, Dr Shock is not very impressed by the results. For significant difference with the primary outcome 6 patients had to be excluded from the analysis. The mean difference between active and sham on the severity scales is in the range of 2-3 points, significant but hardly clinical relevant. The NICE guidelines use a difference of .....read more »