a media webinar co-hosted by the science media centre of canada brain stimulation therapies for...
TRANSCRIPT
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A media webinar co-hosted by the Science Media Centre of Canada
Brain stimulation therapies for mental illness
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Speakers
Dr. Mark George, Distinguished University Professor, Medical University of South Carolina
Dr. Jeff Daskalakis, Temerty Chair in Therapeutic Brain Intervention, CAMH
Gail Bellissimo
Dr. Benoit Mulsant, Physician-in-Chief, CAMH
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How rTMS became a useful therapyfor treatment-resistant depression
• rTMS – repetitive transcranial magnetic stimulation: focused magnetic field pulses are applied externally to stimulate brain regions involved in regulating emotions
• a non-invasive treatment with few side effects (unlike ECT, rTMS does not induce a seizure)
• Developed in 1985, with many studies throughout the 1990s on TMS as a treatment for depression
• more than 100 randomized controlled trials on TMS for depression
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Current rTMS research on suicidality
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Who can benefit from rTMS?
• 4.8% of Canadians surveyed reported a major depressive episode in the previous year
• 1 in 3 people with depression do not respond to current medications or psychotherapy
• Up to 274,000 people with treatment-resistant depression in Ontario alone in 2014
• Symptoms improve in half of those receiving rTMS, and more than one-third achieve complete remission
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Temerty Centre for Therapeutic Brain Intervention at CAMH
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Access to rTMS
• rTMS approved by Health Canada for depression treatment in 2002 (US FDA in 2008)
• treatment fee reimbursed in Saskatchewan, Quebec; other provinces are considering reimbursement
• limited availability e.g. approx. 10 clinics in Ontario vs. 50 for ECT
• estimated costs of untreated treatment-resistant depression: $19,182 per person
• estimated cost per full remission for rTMS: $6,580*
*based on same session fee as ECT
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Gail Bellissimo
“rTMS is allowing me to thrive, not just survive.”
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tDCS for Alzheimer’s prevention
• tDCS - transcranial direct current stimulation: a constant, low-intensity electrical current passes through two electrodes on the head to stimulate specific parts of the brain
• a non-invasive and painless procedure
• a procedure that has led to temporary cognitive improvements
• currently being studied in a novel prevention intervention in combination with cognitive exercises
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• in 2011, about 15 per cent of Canadians aged 65 or older were living with cognitive impairment, including dementia
• current treatments provide symptom management, but the disease is progressive
• delaying diagnosis of Alzheimer’s disease could have a huge impact on reducing the burden of illness
Who could benefit from tDCS?
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tDCS kit
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Current study: PACt-MD
• Preventing Alzheimer’s and dementia with Cognitive remediation plust tDCS in MCI and Depression
• target population is older adults at high risk of Alzheimer’s disease: those with mild cognitive impairment and/or a recent depression
• goals are to prevent or slow down cognitive impairment, thus delaying diagnosis of dementia
• five-site study with 375 people who will be followed for up to five years to assess the impact of this novel intervention
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PACt-MD
PreventingAlzheimer’s dementia withCognitive remediation plustDCS inMCI andDepression
Contact: Sara GambinoResearch AnalystCAMH416-535-8501ext. 33657