Magnetic stimulation, ultrasound, light and electric impulses in the brain can treat even previously treatment-resistant anxiety and depression. Find out:

  • How brain stimulation and neuromodulation work to cure anxiety and depression
  • How brain stimulation can beat out medication-based treatments, with reduced side effects and increased effectiveness
  • Which methods currently exist, and what conditions they can treat
  • Which newly developing methods could become premiere treatments
  • How brain stimulation can treat conditions like insomnia, PTSD, OCD, Parkinson's, and addiction

Most of those afflicted by anxiety and depression try several antidepressant treatments before they find one that works, and 40-60% of sufferers don't adequately respond to medication-based treatment. All medications work differently and present different side effects, and finding the right one can be a laborious, time consuming process. Alternative methods of treatment, like brain stimulation, offer a more direct, effective approach towards treating mental health issues.

Several of these new neuromodulation treatments, which focus on directly stimulating nerves in the brain with electrical impulses, have recently been approved by the FDA as anxiety and depression treatment methods. In a recent study published in Brain Stimulation, Dr. Alexander Bystritsky examines the pros and cons of current neuromodulation treatments, and suggests that a currently underexplored brain stimulation method, called low-intensity focused ultrasound pulsation (LIFUP), could be an exciting new avenue for anxiety and depression treatment.

Deep Brain Stimulation and Neuromodulation Methods can be Used to Treat Depression

One of these recently approved new treatments is Deep Brain Stimulation, previously used to treat tremors and Parkinson's Disease. The method involves the surgical implantation of a brain pacemaker that transmits electrical signals to certain parts of the brain, and the process has been shown to significantly reduce major depression symptoms in several treatment-resistant individuals. Though Deep Brain Stimulation has been shown to be effective in preliminary clinical trials, especially for those who are resistant to most other attempts at treatment, it's a highly invasive surgical procedure that requires moderate upkeep, and may not be possible or convenient for some patients.

Similarly, vagus nerve stimulation (VNS) and repetitive transcranial magnetic stimulation (rTMS) have recently been FDA approved for the treatment of depression. Both work in analogous ways, and both have also been shown to improve depression and anxiety in previously treatment-resistant individuals. However, they also have drawbacks - similar invasiveness for VNS, and an inability to target deeper parts of the brain for rTMS. Additionally, all these methods are difficult to use in conjunction with functional MRI (fMRI), meaning that it's hard for doctors to simultaneously visualize specific neuronal circuits with fMRI and treat these parts of the brain with the neuromodulation method in question.

Other Brain Stimulation Methods Could Offer Benefits for Mental Health Patients

Many other tools for brain stimulation currently exist, some FDA approved and some still awaiting approval. A couple of notable methods include transcranial direct-current stimulation (tDCS), cranial electrotherapy stimulation (CES), and deep repetitive transcranial magnetic stimulation (DRTMS). tDCS is a non-invasive, relatively simple device that uses electrodes placed over the head to excite neuronal activity with anode stimulation, or reduce neuronal activity with cathode stimulation. Research suggests that tDCS can be used to treat anxiety, depression, chronic pain, and Parkinson's disease, though the method had not yet been FDA approved.

CES is similarly non-invasive, and uses a small, palm-sized device to send small electric currents across the brain. The method is currently FDA approved as a Class III regulated device for treating anxiety, depression, insomnia, and chronic pain, and is valued for ease of use - patients can use the device at home. However, recent studies have begun to question the effectiveness of the method, and are re-examining positive results found in previous studies.

Deep rTMS, or DRTMS, is an encouraging new variation of rTMS which targets deeper regions of the brain to produce higher levels of effectiveness in treating depression and anxiety symptoms than regular rTMS.

Of course, there's even more methods out there: research into neuromodulation and brain stimulation is constantly evolving and new techniques are being developed, among them methods utilizing light and ultrasonic energy. Brain stimulation is valuable for the low incidence of side effects in comparison to medication, and for its ability to show improvement in previously treatment-resistant individuals. Studies have been conducted studying the positive effects of neuromodulation methods on everything from autism spectrum disorder to ADHD, OCD, PTSD, and smoking cessation. Brain stimulation remains an exciting, blooming field of research for mental health treatment, and Dr. Bystritsky suggests that one of these newly developing methods, LIFUP, could be a strong contender in future depression and anxiety treatment.

The Advantages of Low-Intensity Focused Ultrasound Pulsation

LIFUP is also a neuromodulation method, meaning that it works similarly to DBS, VNS, rTMS, and others in that it utilizes energy pulses to excite and suppress neuronal activity. However, LIFUP is different because it uses ultrasound, which can be focused non-invasively through the skull and which has entirely reversible effects on neurons. Ultrasound energy is mechanical rather than electromagnetic, minimizing interference with MRI technology and offering healthcare professionals the avenue of simultaneously using LIFUP with fMRI for brain mapping. The last decade has seen research on the neuromodulating properties of LIFUP pick up, though testing on humans has been minimal. However, the testing that has been conducted hints at the possibility for entirely safe use of the method, with researching showing that damage caused by LIFUP is nonexistent, and that even 48 hours of constant LIFUP stimulation failed to cause damage or alterations in neuronal membranes.

More Research and Experimentation with LIFUP is Needed

In the light of FDA approval of DBS, VNS, and rTMS for the treatment of disorders including depression, encouraging further research on LIFUP is more important than ever. LIFUP offers several benefits over other brain stimulation treatments, and with more clinical testing the method could become a strong tool for diagnosing and treating mental health issues. Research also suggests that LIFUP could be a potential treatment method for other neurologic disorders such as chronic pain, obesity, and Parkinson's disease, and utilization of the method could become an important middle ground between medication-based treatments and invasive procedures like DBS.


Definitions:

Neuromodulation is a method of treating disorders that works by stimulating nerves, usually in the brain but possibly in other areas of the body. This stimulation modulates, or alters, neurological activity in a way that is non-permanent and reversible.

Functional magnetic resonance imaging (fMRI) is a procedure which maps and measures brain activity by recording changes in blood flow. It uses magnetic resonance imaging technology to display neural activity in the brain.

Types of Brain Stimulation Methods:

Vagus nerve stimulation (VNS) is a form of brain stimulation therapy that involves the surgical implantation of a device which stimulates the vagus, or the tenth cranial nerve. The method was FDA approved for the treatment of depression in 2005, and is currently being researched as a treatment method for anxiety disorders, among other illnesses.

Repetitive transcranial magnetic stimulation (rTMS) is a neuromodulation method in which an electromagnet is placed against a patients' scalp and passes magnetic energy pulses to a certain part of the brain. This magnetic stimulation works to reset brain wave frequencies, and has been approved by the FDA as a depression treatment method.

Deep repetitive transcranial magnetic stimulation (DRTMS) is a new type of rTMS with the ability to access deeper parts of the brain, overcoming a previous limitation of the method and producing stronger clinical results.

Deep brain stimulation (DBS) is a neuromodulation method currently FDA-approved for treating Parkinson's Disease, dystonia, and obsessive compulsive disorder, though the treatment has shown positive clinical results for major depression and chronic pain. The process involves surgically implanting a pacemaker-like device into the chest which sends electrical impulses to certain parts of the brain.

Transcranial direct-current stimulation (TDCS) is a non-invasive form of brain stimulation in which two electrodes, an anode and a cathode, are attached to different parts of the scalp, and low level currents are transmitted through different areas of the brain. Current through the anode works to stimulate and excite brain neuron activity, while current through the cathode impedes and slows activity. The method is not currently FDA approved, but clinical research has suggested benefits in treating chronic pain, treatment-resistant major depression, and addiction, among others.

Cranial electrotherapy stimulation (CES) is a non-invasive, easy to use neuromodulation method currently FDA approved as a regulated device for treating anxiety, insomnia, and depression. Though the method has been on the market for over 30 years, current research has cast doubts on its effectiveness.

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Date of original publication:

Updated: October 08, 2016