The Promise of TMS: Interview with Neuronetics Chief Medical Officer Mark Demitrack

The Promise of TMS: Interview with Neuronetics Chief Medical Officer Mark Demitrack

The NeuroStar TMS Therapy System is the first and only TMS device cleared by the U.S. Food and Drug Administration (FDA) to treat patients with Major Depressive Disorder (MDD) who have not benefited from initial antidepressant treatment.* This breakthrough depression treatment uses a highly focused, pulsed magnetic field, similar in type and strength to those produced by a magnetic resonance imaging (MRI) machine, to stimulate function in brain regions known to affect mood. The NeuroStar TMS Therapy System utilizes several unique patented technologies to maximize patient treatments:

SenStar® Treatment Link – The link to safe, effective and tolerable treatment

MT Assist® – Unique software makes finding the right treatment dose easy

Precision Pulse TMS™ Technology – Patented coil design improves efficiency which increases patient throughput

Coil Positioning System – Integrated positioning system assures repeatable and accurate treatment.

TMS TrakStar™ – Proprietary patient database that facilitates TMS reporting and documentation

The NeuroStar® System was designed for therapeutic use. To guide our customers in establishing and operating a successful TMS clinic, Neuronetics provides all key system components and software as well as clinical training and services as part of the cost of the NeuroStar TMS Therapy System.

View the NeuroStar TMS Therapy System components

*NeuroStar TMS Therapy® is indicated for the treatment of Major Depressive Disorder in adult patients who have failed to achieve satisfactory improvement from one prior antidepressant medication at or above the minimal effective dose and duration in the current episode. Click here for full prescribing and safety information.

Transcranial magnetic stimulation (TMS) has been studied as a potential therapy for disorders ranging from drug addiction to bipolar disease. The premise is that pulsed, MRI-grade magnetic fields can locally excite or inhibit regions of the cerebral cortex, thus affecting neurological function. The makers of the NeuroStar TMS System, Neuronetics, contacted us to let us know about their new study released at the American Psychiatric Association meeting in May. In brief, they treated patients who have unipolar, non-psychotic Major Depressive Disorder (MDD) with TMS and found that:

Overall, 58 percent of patients achieved a positive response to NeuroStar TMS therapy, with 37 percent of patients achieving remission from their depression.

After an average of five weeks of NeuroStar treatment, the percentage of patients reporting extreme problems with anxiety and depression decreased by 42.2 percent, demonstrating a reduction in depression symptomatology. For overall treatment effect, the percentage of patients reporting no problems in performing usual activities improved by 30.5 percent.

Medgadget had the opportunity to interview Neuronetics’ Chief Medical Officer to discuss the study and the NeuroStar TMS Therapy system.

Shiv Gaglani, Medgadget: What is unique about this study as compared to other studies that show TMS’ effects on depression?

Mark A. Demitrack M.D. The Promise of TMS: Interview with Neuronetics Chief Medical Officer Mark Demitrack, M.D.Mark A. Demitrack, M.D.: This study expands on prior work by showing that TMS has effects not just on the symptoms of depression (eg, sadness, anxiety, sleep, libido, appetite, et cetera), but also is able to demonstrate improvements in the ability for a person to resume normal life activities and experience an improved ability to function in day to day activities. In other words, the improvement in mood translates into improvements in real life activities.

Medgadget: How does TMS improve affect among depressed patients? What brain region(s) does it excite/inhibit?

Dr. Demitrack: We believe TMS exerts its effects by improving the metabolic activity (ie, the energy production) in the specific areas of the brain that we know are involved in the regulation of mood. The direct target of action is the left dorsolateral prefrontal cortex (the region right under the left front part of the head). The effects that are exerted there are also exerted indirectly on other areas of the brain that are connected to the DLPFC, including the anterior cingulate cortex, the amygdala and the hippocampus, among others.

Medgadget: What is the strength & penetration depth of the magnetic pulses?

Dr. Demitrack: The magnetic field produced by the NeuroStar TMS system is about 1.5 Tesla, or about the strength of a standard MR imaging device. The magnetic fields reach to a depth of about 3 – 4 cm into the brain directly.

Medgadget: Were any side effects observed?

Dr. Demitrack: The most common side effect directly related to the device is scalp pain or discomfort at the site of stimulation. Most patients find this to be mild to moderate in intensity, and it usually becomes unnoticeable after the first week.

Medgadget: What are NeuroStar’s next steps (e.g. FDA approval, studying TMS in other psychiatric populations)?

Dr. Demitrack: We continue to explore other areas of potential use of TMS in a variety of brain diseases.

Here’s a promo video for the company’s TMS therapy system:

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