Posted by Pfinstegg on September 7, 2003, at 22:14:37
I wanted to let people interested in TMS know that I just returned from having 6 "booster" sessions of TMS with Dr. Mark Hutto of Atlanta. I had a course of 15 sessions last January, which resulted in an excellent four-month remission; however a degree of depression returned in April, which did not respond fully to Lexapro. I decided to return to Atlanta for twice-daily booster sessions for three days. It worked just as well as it did before- no depression whatsoever at the moment!
I asked Dr. Hutto what he thought the mechanisms of action of TMS were. He cited four things which are thought to occur, but noted that research is just beginning in these areas. They are:
1. an increase in blood flow to the left frontal region.
2. an increase in production of BNDF, allowing neuronal growth to occur. While the direct effect of TMS is limited to about 2-3 cm. beneath the skull, it is thought that there is a sort of "chain reaction" reaching into the limbic system and hippocampus. Some researchers think that regular birth of new neurons in these sub-cortical regions is needed to prevent depression, so the reported action of BNDF sounded really promising!
3. Stimulation of neurons in the limbic system in a way that increases the production of dopamine, norepinephrine and serotonin. There are so few ways to increase dopamine, so this was especially exciting- I really think it's true, too- I'm able to enjoy everything fully right now.
4. An inhibitory effect on the hypothalamus, decreasing the production of Corticotrophin Releasing Factor, and thus dampening the overactive HPA axis, and abnormally high releases of cortisol, which are probably the causative factors in damage to the neurons of the hippocampus- and in the onset of severe depression.
Well, if these things are true, it's a perfect anti-depressant- just in a magnetic coil rather than in a bottle! It has worked so extremely well for me that I plan to return for regular treatment on an as-needed basis, even though it's a huge pain in the neck to do so.
As to the details of the treatment, it was given to the left dorso-lateral prefrontal area, five centimeters forward of the motor area to the right thumb- at 10 Herz (in groups of 200 pulses per 20 seconds- this was repeated 40 times for each treatment-("40 trains"). The intensity of the pulses was %110 of the motor threshold.
Pfinstegg
poster:Pfinstegg
thread:257943
URL: http://www.dr-bob.org/babble/alter/20030903/msgs/257943.html