Study: MRIs in depression treatment could ease symptoms for longer

Using MRI scans to deliver targeted magnetic stimulation to depressed people’s brains could ease symptoms for six months, researchers have suggested.

Transcranial magnetic stimulation (TMS) is a method which uses magnetic pulses to stimulate areas of the brain, and is usually delivered in sessions over four to six weeks.

According to academics at the UK's University of Nottingham, symptoms in depressed patients usually ease for one to three months following treatment.

However, the BRIGhTMIND trial explored ways to extend the benefits by ensuring the same area of the brain was targeted at each session, with results suggesting this could improve symptoms for at least six months.

The team gave patients an MRI scan before staring TMS, which allowed researchers to target where the different brain systems involved in depression meet.

The second scan was taken 16 weeks after the first TMS session and looked at chemicals in the brain to help the team understand how the patient responded to the treatment.

The trial used neuronavigation, a computerised tracking system using light to deliver the TMS.

Richard Morriss, a professor of psychiatry at the University of Nottingham’s School of Medicine and lead for the Centre for Mood Disorders at the Institute of Mental Health, said: “Ideally when people come for a TMS session, they would sit in the exact same place, but this is rarely going to happen.

“This method uses light from both ear lobes and the top of the nose to measure the stimulation point from the first time a patient has the treatment.

“The MRI personalises the site of stimulation and then neuronavigation makes sure the same site is being stimulated at each treatment session.

“This reduces the variability in stimulation at each session. Since the magnetic pulse can be focused, there are usually only minor short-lasting side-effects, and the person can return to their daily activities immediately on return from the hospital.”

Some 255 people took part in the trial and completed 20 TMS sessions.

It was found that targeted TMS led to “substantial improvements” in the severity of patients’ depression and anxiety, with better function and quality of life over 26 weeks.

Researchers said more than two thirds of patients responded to the treatment, with a fifth moving into remission and staying there.

Prof Morriss described the results, published in Nature Medicine, as “encouraging”.

“Given these patients are people who have not responded to two previous treatment attempts and have been ill for an average of seven years, to get such a significant response rate and a fifth who have a sustained response is really encouraging,” he said.

“Patients who responded to the treatment could stay relatively well compared to how they were previously, with as little as one or two treatments a year.

“The changes we saw were substantial, not only in reducing their depression symptoms, but they were large enough to improve concentration, memory, anxiety and subsequently their quality of life.”

The BRIGhTMIND trial was funded by the a National Institute for Health and Care Research (NIHR) and Medical Research Council (MRC).

Professor Danny McAuley, scientific director for NIHR Programmes, said: “These are important findings showing this novel technique can hugely benefit patients with severe depression which has not responded to other treatments.”