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# Discover NIMH: Personalized and Targeted Brain Stimulation Therapies

November 12, 2019

## Transcript

>> DR. JOSH GORDON: Brain stimulation therapies are important and effective treatments for people with depression and other mental disorders. The National Institute of Mental Health, NIMH, is supporting studies exploring how to make brain stimulation therapies like electroconvulsive therapy or ECT and transcranial magnetic stimulation or TMS more personalized and effective while reducing side effects.

>> DR. SARAH LISANBY: And I learned about ECT because one of my patients had to receive it. She was severely depressed and had a form of depression called catatonia. This can be life-threatening. And after her first ECT treatment, she was able to talk, she was able to move, she was able to eat. It really was life-saving for her.

>> DR. MATTHEW RUDORFER: Dr. Lisanby has done groundbreaking work in neurostimulation. She has brought ECT closer to the mainstream in the development of new and exciting neurostimulation treatments that offer options for people, especially with resistant depression. She has shown how we can optimize existing treatments such as electroconvulsive therapy and using magnetic stimulation, develop totally new approaches which did not exist a generation ago.

>> DR. SARAH LISANBY: Transcranial magnetic stimulation, or TMS, is the noninvasive way of stimulating the brain. It's a tool that we can use to study brain function but really excitingly, it's now a treatment that we can use for depression. We are seeking to develop new tools to improve the potency of TMS, how we can optimize, make it more effective for every person with depression by figuring out how to personalize the treatment. Finally, we have a tool that can not only teach us about depression and other serious illnesses but actually do something about it.

>> DR. JOSH GORDON: ECT and TMS both stimulate the brain with electricity but unlike ECT in which electrical stimulation is more generalized, TMS can be targeted to a specific site in the brain. TMS is a tool that is widely used to study complex aspects of brain function. NIMH-supported studies are exploring TMS's potential as a novel therapeutic treatment for mental disorders.

>> DR. SARAH LISANBY: We're seeking to improve the safety of our most effective treatments, including electroconvulsive therapy. TMS has a better safety profile. It doesn't affect memory. And one of the things that we're doing right now is coupling TMS with therapy. We're using the therapy to activate the circuits of the brain that are important for responding to treatment, and we stimulate using TMS to enhance the learning process during therapy.

>> DR. MATTHEW RUDORFER: Dr. Lisanby has taken essentially a 20th-century treatment, ECT, and brought it into the 21st century using modern neuroscience. We can get the therapeutic effect we want but avoid many of the adverse effects which has plagued treatments like electroconvulsive therapy in the past.

>> DR. JOSH GORDON: TMS is an FDA-approved treatment used for depression and obsessive-compulsive disorder. NIMH-funded research is now seeking to understand the mechanisms underlying its effects and to develop TMS treatments for conditions like anxiety disorders and post-traumatic stress disorder where it has shown some promising results.

>> DR. MATTHEW RUDORFER: Patients used to feel that if they were referred for ECT, that was their last resort, that was the end of the line, and, in fact, that's not the case.

>> DR. SARAH LISANBY: TMS has gone from a research tool to something that is really making a difference in peoples' lives. There's nothing more rewarding than seeing a person respond, seeing a person go from the depths of depression, hopelessness, even having thoughts of wanting to end their life, and to have that melt away and have them return to the person that they were before the serious disease of depression had affected them.

>> DR. JOSH GORDON: Through these and many other research projects, NIMH is striving to bring hope, therapies, and treatments to individuals and families affected by mental disorders.