TMS in the veteran population!
According to the linked article, at the Hampton Veternas Affairs Medical Center, Dr. Kenneth Miller is investigating if transcranial magnetic stimulation can be used to treat depression that failed to respond to conventional methods. Dr. Miller performed a demonstration where a veteran underwent treatment, where every 20 seconds, 36 pulses were delivered to the dorsolateral prefrontal cortex. A four year study conducted on veterans who receive TMS published in June 2018 in the Journal of American Medicine Association Psychiatry showed that as many as 20% of patients may fail to respond to conventional treatments such as antidepressants and psychotherapy. TMS, on the other hand delivers pulses to the brain to activate nerve cells in the cerebral cortex. Overtime, the use of TMS has become more widespread. Eastern Virginia Medical School has been providing this since 2010. It is also offered by Virginia Commonwealth University and the University of Virginia.
Other uses for TMS that are being investigated include use for strokes, traumatic brain injury, addiction, and posttraumatic stress disorder (PTSD). Dr. Serina Neumann has also been actively studying this for the treatment of PTSD in combat veterans.
Another interesting point is that Dr. Mark George, at the Medical University of South Carolina, directed the Brain Stimulation Laboratory and co-directed a VA clinical trial of 164 veterans who had TMS or sham treatment. 40% of the TMS group reported remission but so did 37% of the sham group. This study used a figure of 8 coil interestingly. It is also possible that these soldiers may have especially benefited from the social interaction during treatment, but the positive aspect is that many participants got their lives back. The Hampton VA in contrast uses an H1 coil, which stimulates more deeply and broadly. Data provided by Brainsway showed that 42% achieved remission after 20 sessions and as many as half of patients after 30 sessions can reach remission. The studies by Brainsway are also controlled for sham treatment.
In the article, veteran Charlene Campbell shared her experience. She was on a seven month deployment where she was a first responder in Dhahran where there was a Scud missile bombing and 27 soldiers were killed. The medication and therapy only took her so far. She knew intellectually where things should be but the feelings just were not there. As she underwent further treatment and had TMS, she started to feel more towards herself that it is still never too late to be the best mother she can be. Overtime, she noticed she started to sleep better and in the second week, that it was easier to bounce back from her anxiety and depression. Admittedly, she wasn’t really sure if remission is something she’d ever achieve, but she reported very mild symptoms and was extremely grateful to have that.