When electricity and the brain are mentioned in the same sentence, your mind might immediately jump to disturbing images of people receiving huge shocks while covered in electrodes, strapped to tables.
But electroconvulsive therapy (ECT) treatment has developed considerably since the days depicted in “One Flew Over the Cuckoo’s Nest.” A current study at JAMA Psychiatry examines a treatment called transcranial Direct Current Stimulation (tDCS).
Could this fairly new form of electrical treatment for depression really be effective — and without the negative side effects of ECT?
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40% of depressed patients do not respond to antidepressnts and are called treatment-resistant.
Dr. Colleen Loo achieved a 50% improvement for treatment-resistant depressed patients utilizing 30 20-minute tDCS treatments over a 6-week period and maintained remission with a single weekly treatment (2012). Had this protocol been utilized instead of the 2/week tDCS treatment protocol Dr. Brunoni used, I believe improvement would have been more robust. Also, Dr. Loo, following her study, questioned whether patients taking antidepressants during the tDCS protocol might have limited the response to tDCS. Because tDCS is easy to do and literally without side effects, home use becomes a viable option, increasing convenience and availability and significantly reducing cost. The lifetime cost of home-use tDCS can be done for a fraction of the cost of a single transcranial magnetic stimulation protocol which provides relief for only 6 months.
I think this is a really cool discovery. Depression affects me as well as many others each year and it’s promising that researchers are working on finding more treatment options besides a pill. I for one am not an activist for antidepressants, with too many side effects medicine alone is a less than ideal treatment for depression.
Although this new study has had promising results for those able to make it to treatment centers where this new option is available. In order for it to be used widespread, doctors would have to be able to create a device more suitable for in-home use. I think this is a great discovery but far from being ready for practical use.
Ok, agreed the effectiveness of this therapy, but what’s the mechanism behind this?
The mechanism is beautiful in its simplicity. The outside of a nerve has a negative charge compared to the inside, -75mV to be exact. When that decreases to -55mV, the polarity reverses for a fraction of a second or depolarizes and the nerve sends its signal. A small negative current inhibits this, a small positive current facilitates this. A large positive current depolarizes all the nerves and causes a seizure which is what’s done in ECT.
I am sick of the drugs…wonder if this could be accomplished with a TENS unit?
no. a tens unit cycles or pulses current forward and back, kind of like ac current. The effect would at best be cancelled out because in order to de-polarize the nerves, you would have to run current in one direction. I believe it is anodal (+) on the right side (position for depression i’m not sure of, perhaps prefrontal cortex?) and cathode on the left side. Please note that when studies concerning cognitive functions were done with the positions reversed in polarity, the associated cognitive functions performance worsened.