A novel approach to treating severe depression using magnetic fields has demonstrated effectiveness comparable to traditional electroconvulsive therapy while better preserving patients’ cognitive abilities, according to a major clinical trial led by researchers at UT Southwestern Medical Center.
The study, published in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, marks a significant advancement in the treatment of major depressive disorder, particularly for patients who haven’t responded to conventional therapies.
“These results substantiate that MST is a safe and beneficial antidepressant neurotherapeutic treatment,” said lead author Shawn McClintock, Ph.D., Professor of Psychiatry and Investigator in the Peter O’Donnell Jr. Brain Institute at UT Southwestern.
The research team conducted a comprehensive trial involving 73 patients with treatment-resistant depression, comparing magnetic seizure therapy (MST) to electroconvulsive therapy (ECT), which has been a standard treatment for severe depression for over eight decades. While ECT remains effective, its use has been limited by temporary but significant effects on memory and cognitive function that can persist for months.
In the study, 38 patients received ECT while 35 underwent MST, with treatments administered three times weekly until they either achieved remission or their improvement plateaued. The research team assessed both depression symptoms and cognitive function before treatment began and again within 72 hours after the final session.
Similar Effectiveness, Different Impacts
The findings revealed that both treatments achieved comparable success rates, with approximately 50% of patients in each group showing significant improvement or achieving remission from depression. ECT patients typically required about seven sessions, while MST patients needed around nine sessions to achieve similar results.
However, the cognitive outcomes differed markedly between the two groups. Patients receiving ECT experienced significant decreases in multiple cognitive areas, including verbal fluency, executive function, and memory retention. In contrast, those treated with MST maintained their cognitive performance across most measures, with some patients even showing improved fine motor skills.
While both groups experienced some decline in autobiographical memory consistency – the ability to recall personal life events – the decline was significantly less severe in the MST group compared to those receiving ECT.
Technical Innovation
MST represents an evolution in seizure therapy, utilizing magnetic fields rather than electrical current to induce therapeutic seizures. The treatment is administered under anesthesia, similar to ECT, but employs technology derived from transcranial magnetic stimulation to target specific brain regions more precisely.
The researchers’ analysis showed that MST patients maintained stable performance in areas of attention, verbal fluency, executive function, and verbal learning and memory. This preservation of cognitive function could make MST particularly valuable for patients who need to maintain their ability to work or manage daily responsibilities during treatment.
Looking Forward
The research team, which included collaborators from Columbia University/New York State Psychiatric Institute and Duke University School of Medicine, plans to conduct larger clinical trials to further compare the two therapies and investigate the mechanisms behind their antidepressant effects.
“We want to do our best to minimize this because it’s one of the biggest deterrents for ECT,” McClintock said. “Some people say that these side effects outweigh the benefits.”
The study was supported by grants from the Stanley Medical Research Foundation, the Brain & Behavior Research Foundation, the National Institute of Mental Health, and the National Center for Advancing Translational Sciences.
As research continues, MST could represent a significant advance in treating severe depression, offering patients and healthcare providers an option that combines the effectiveness of ECT with better preservation of cognitive function. The treatment remains under investigation and would require FDA approval before becoming widely available to patients.
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