The Mood Disorders Research Clinic at Butler Hospital in Providence, Rhode Island, is one of the first research sites in the country that is enrolling participants in a clinical trial testing the effectiveness of a small, portable machine for treating depression. Synchronized transcranial magnetic stimulation (sTMS) is a new brain stimulation treatment that may alleviate symptoms of depression. The specific device being tested is called the NeoSync EEG-Synchronized TMS, or “NEST.” The goal of the NEST study is to see if the treatment can reset the brain back to its normal non-depressed state with a series of magnetic energy stimulation treatments delivered to patients while they are awake.
Activity of nerve cells (neurons) in our brains continuously produces electrical energy that can be measured on the scalp using an electroencephalogram (EEG) machine. With a modified EEG recorder, the investigational NEST device reads the patient's alpha brain waves at the start of treatment. The device generates a low energy magnetic field that is synchronized to the patient’s individual alpha wave pattern. Alpha brainwaves are believed to regulate normal brain function, and the sTMS device is thought to bring about clinical improvement through establishing normal brain rhythm patterns in patients with major depression.
The sTMS study is open to adults who have completed at least one full course of treatment for their depression using an antidepressant medication, but who still remain symptomatic despite the medication trial. Each sTMS treatment lasts for about 30 minutes, is essentially painless, and is delivered to patients who are awake. Participants must be able to come to the research clinic at Butler Hospital to receive a 30-minute treatment every weekday, Monday to Friday, for six weeks. No anesthesia or sedation is involved, so patients can drive to and from their treatment sessions.
According to Linda M. Carpenter, MD, chief of Butler Hospital’s Mood Disorders Program and a professor of psychiatry at the Alpert Medical School of Brown University, only a small number of people have reported side effects, usually mild cases of insomnia. Data from preliminary studies have shown that the NEST device improves depressive symptoms, so larger scale studies are now underway to confirm the efficacy of sTMS.
Dr. Carpenter says recent neuroscience research suggests alpha waves are important for modulating the connections between brain regions that are involved in mood, and they are thought to play an active role in controlling and coordinating multiple functions in the brain for optimal production of thoughts or behaviors. The NEST device, developed by the NeoSync company in Waltham, Massachusetts, uses some of the latest technology to stimulate the brain in a safe way that may provide a novel treatment option for those whose depression has not responded to standard medication.
In 2009, Butler Hospital opened one of the first neuromodulation clinics to offer (repetitive) transcranial magnetic stimulation (rTMS, or simply “TMS”) for treating depression, after approval by the Food and Drug Administration (FDA) of the NeuroStar device for that purpose. The Butler TMS clinic has been active in both clinical service and research since then. While standard rTMS uses large amounts of magnetic energy that are pulsed rapidly through the skull, the new investigational NEST therapy only uses a small amount of energy to alleviate symptoms of depression or alter the alpha waves to alleviate depression.
Depression is among the most common forms of brain-based illnesses. Estimated to affect over 17 million people in the United States, it can cause untold suffering and can play a role in problems at home, school, and work and often occurs with other serious medical conditions including heart disease, cancer, and stroke.
Butler Hospital is the only private, nonprofit psychiatric and substance abuse hospital serving adults, adolescents and children in Rhode Island and southeastern New England. The flagship hospital for psychiatry at the Warren Alpert Medical School of Brown University, Butler is recognized worldwide as a pioneer in conducting cutting-edge research.