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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by Hugh on October 26, 2015, at 13:56:12
This low-field magnetic stimulation study is currently recruiting subjects with treatment-resistant depression. It's being conducted at ten locations in California, Florida, Georgia, Ohio, Texas and Washington state.
https://clinicaltrials.gov/ct2/show/NCT02452892
Here's an article about LFMS:
http://news.harvard.edu/gazette/story/2014/07/new-treatment-for-depression-shows-immediate-results/
Posted by linkadge on October 26, 2015, at 16:19:42
In reply to Recruiting TRD patients for LFMS study, posted by Hugh on October 26, 2015, at 13:56:12
You can use strong stationary magnets (waved over the head) to influence mood. I use a strong woofer speaker magnet, I pass it back and forth over my head.
It works.
Linkadge
Posted by Hugh on November 13, 2015, at 14:19:50
In reply to Recruiting TRD patients for LFMS study, posted by Hugh on October 26, 2015, at 13:56:12
The clinical trial they're currently recruiting treatment-resistant depression patients for has added another two locations, bringing the total number of test sites to twelve.
https://clinicaltrials.gov/ct2/show/NCT02452892
Here's another article about the treatment:
http://news.harvard.edu/gazette/2004/01.22/01-depression.html
Posted by SLS on November 13, 2015, at 15:53:18
In reply to Re: Recruiting TRD patients for LFMS study, posted by Hugh on November 13, 2015, at 14:19:50
> The clinical trial they're currently recruiting treatment-resistant depression patients for has added another two locations, bringing the total number of test sites to twelve.
>
> https://clinicaltrials.gov/ct2/show/NCT02452892
>
> Here's another article about the treatment:
>
> http://news.harvard.edu/gazette/2004/01.22/01-depression.htmlThis disgusts me. They have known about this stuff for over 10 years. What the hell have they been waiting for? It's a friggin' MRI for God's sake. Just use the damned thing. Worry about statistics and mechanisms later.
- Scott
Posted by Hugh on November 13, 2015, at 17:48:35
In reply to Re: Recruiting TRD patients for LFMS study, posted by SLS on November 13, 2015, at 15:53:18
Scott,
I couldn't agree more. I first read about this treatment nearly twelve years ago, and it's only now that these trials are getting underway. Of all the experimental depression treatments I know of, this one sounds the most promising. It's maddening that this is progressing so incredibly slowly.
Posted by Deahoidar on November 13, 2015, at 23:36:19
In reply to Recruiting TRD patients for LFMS study, posted by Hugh on October 26, 2015, at 13:56:12
Reading the description of the clinical trial, it is clear that they are not looking to treat people with serious refractory depression. I was disappointed to realize this. The exclusionary criteria include any person who has failed 4 or more medications, or had ECT, and on and on. Seems they are looking for something to market alongside TMS?
Posted by Hugh on November 14, 2015, at 9:47:54
In reply to Any luck potentiating/supplementing MAOIs?, posted by Deahoidar on November 13, 2015, at 23:36:19
LFMS appears to be far more effective than TMS. I found this quote from the 2004 article interesting:
"The researchers are intrigued by the fact that all of the manic-depressives not on medication responded favorably, as opposed to two-thirds of those taking drugs."
Posted by SLS on November 14, 2015, at 12:52:40
In reply to Re: Any luck potentiating/supplementing MAOIs? » Deahoidar, posted by Hugh on November 14, 2015, at 9:47:54
> LFMS appears to be far more effective than TMS. I found this quote from the 2004 article interesting:
>
> "The researchers are intrigued by the fact that all of the manic-depressives not on medication responded favorably, as opposed to two-thirds of those taking drugs."There was some conjecture that increasing the intensity of stimulation could offset being medicated. I hope so.
- Scott
Posted by Deahoidar on November 18, 2015, at 17:31:50
In reply to Re: Recruiting TRD patients for LFMS study » SLS, posted by Hugh on November 13, 2015, at 17:48:35
From the articles, it sounds like they are only treating "depression" in bipolar subjects, and some of those are not on any medication for their mood disorder.
It would really help if they were more transparent about how severe the participants' illness had to be, and how they measured their levels of "depression" before and after.
Some well designed double-blind, randomized, clinical trials could really help to determine if this is serious and effective treatment or merely more magnet-waving magic.
Posted by SLS on November 18, 2015, at 21:22:48
In reply to Re: Recruiting TRD patients for LFMS study, posted by Deahoidar on November 18, 2015, at 17:31:50
> From the articles, it sounds like they are only treating "depression" in bipolar subjects, and some of those are not on any medication for their mood disorder.
>
> It would really help if they were more transparent about how severe the participants' illness had to be, and how they measured their levels of "depression" before and after.
>
> Some well designed double-blind, randomized, clinical trials could really help to determine if this is serious and effective treatment or merely more magnet-waving magic.Are there any brain stimulation treatments - other than ECT - that you favor? What about deep rTMS (Brainsway device)?
Thanks.
- Scott
Posted by Hugh on November 20, 2015, at 11:12:35
In reply to Re: Recruiting TRD patients for LFMS study, posted by Deahoidar on November 18, 2015, at 17:31:50
> From the articles, it sounds like they are only treating "depression" in bipolar subjects
In the first clinical trial, they were only looking at bipolar subjects. In the trial that is currently underway, bipolar subjects are excluded. They are only looking at unipolar subjects.
Here's a very detailed description of LFMS. In this article, LFMS is called EP-MRSI.
http://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.161.1.93
Posted by Deahoidar on November 21, 2015, at 23:13:02
In reply to Re: Recruiting TRD patients for LFMS study » Deahoidar, posted by SLS on November 18, 2015, at 21:22:48
> Are there any brain stimulation treatments - other than ECT - that you favor? What about deep rTMS (Brainsway device)?
>
> Thanks.
>
>
> - ScottI can't say I favor any treatments. Having severely refractory, neuroprogressive major depression is &#$!ed up. I would prefer not to have this disease.
That said, for patients with severe major depressive disorder who are moderately to severely treatment-resistant, I'm inclined to view TBS (Theta-Burst Stimulation) as the most promising non-invasive treatment.
DBS (Deep Brain Stimulation) continues to show promise among (very) invasive treatments but the failures of two major clinical trials of DBS for refractory MDD and the risks of significant adverse effects have shown just how little we know about severe depression and the brain.
Posted by Deahoidar on November 21, 2015, at 23:27:28
In reply to Re: Recruiting TRD patients for LFMS study, posted by Hugh on November 20, 2015, at 11:12:35
How I hope and wish that LFMS (or whatever they want to call it) would actually be proven to be significantly effective at treating MDD. It really needs some well-designed double-blind clinical trials to establish some credibility.
The studies to-date (e.g., Rohan et al) have been interesting but lacked much-needed rigorous scientific design.
Namely, the study wasn't designed to measure the duration of improvement. Mood was evaluated shortly after treatment but not subsequent assessments were performed. Not even 24 hours later.
Another significant concern regards the questionable reliability of the outcome measures over such short periods of time. The study used a scale that requires assessment of patient condition over the past week. How useful can that be when it is used to measure changes over less than an hour?
I'm also concerned by the small size of the study and the fact that it was not a double-blind study.
I truly hope the scientists design and conduct rigorous clinical trials to determine the efficacy of this potential treatment. For patients suffering from the more severe and insidious forms of MDD, simply waving magnets over their heads doesn't cut it and sounds like something all those well meaning people say to "help".
Posted by SLS on December 6, 2015, at 8:35:47
In reply to Re: Recruiting TRD patients for LFMS study, posted by Deahoidar on November 21, 2015, at 23:13:02
Hi.
Thank you for your response.
> > Are there any brain stimulation treatments - other than ECT - that you favor? What about deep rTMS (Brainsway device)?
> I can't say I favor any treatments. Having severely refractory, neuroprogressive major depression is &#$!ed up. I would prefer not to have this disease.
> ...for patients with severe major depressive disorder who are moderately to severely treatment-resistant, I'm inclined to view TBS (Theta-Burst Stimulation) as the most promising non-invasive treatment.
I never heard of this. Interesting. Thanks.
I'm looking at this:
Direct Current Stimulation
http://bipolarnews.org/?p=3493
- Scott
Posted by Deahoidar on December 6, 2015, at 23:27:38
In reply to Re: Recruiting TRD patients for LFMS study » Deahoidar, posted by SLS on December 6, 2015, at 8:35:47
Scott,
If you try DCS please report back as I would be very interested in your experience. It appears to be a technology that needs some good clinical trials with depressed patients in order to establish its efficacy.
Theta-Burst is a variant of TBS and there are a number of others. So far I've only read case studies and open label trials but some of them are very impressive at treating highly refractory Treatment-Resistant Depression.
This video by a leading Canadian researcher is rather impressive if the results hold up:
https://youtu.be/-qSfVMDQtHw
Posted by SLS on December 7, 2015, at 6:55:56
In reply to Re: Recruiting TRD patients for LFMS study » SLS, posted by Deahoidar on December 6, 2015, at 23:27:38
Hi.
Thanks much for the link to the video.
> Scott,
> If you try DCS please report back as I would be very interested in your experience. It appears to be a technology that needs some good clinical trials with depressed patients in order to establish its efficacy.
> Theta-Burst is a variant of TBS and there are a number of others. So far I've only read case studies and open label trials but some of them are very impressive at treating highly refractory Treatment-Resistant Depression.
> This video by a leading Canadian researcher is rather impressive if the results hold up:> https://youtu.be/-qSfVMDQtHw
That's pretty amazing stuff. I hope other research groups can repeat the results.UNFORTUNATELY, part of their findings is that the people who have anhedonia do not respond to it - dammit.
:-(
At least there is some indication that DBS works for anhedonic depression.
- Scott
Posted by Deahoidar on December 8, 2015, at 0:04:44
In reply to Re: Recruiting TRD patients for LFMS study » Deahoidar, posted by SLS on December 7, 2015, at 6:55:56
I noticed the same thing. TMS, whatever the technique, doesn't seem to help those patients with severe anhedonic depression. I'm beginning to wonder if perhaps there is some neuro-toxic aspect of repeated episodes of depression that does irreparable damage to a key part of the brain. Who knows.
As for DBS, they really have to go back to square one and figure out what it is doing. Two major clinical trials were unable to separate actual DBS stimulation from sham stimulation, meaning that placebo could possibly explain a lot of the supposed efficacy. I know I was one of the non-responders, both to sham and actual stimulation.
Let's hope that something promising develops before long.
Posted by Hugh on December 11, 2015, at 11:39:15
In reply to Re: Recruiting TRD patients for LFMS study » Deahoidar, posted by SLS on December 7, 2015, at 6:55:56
This Yahoo group is a good place to learn about tDCS. There hasn't been any new activity in months, but the archives and files contain a lot of valuable information.
https://groups.yahoo.com/neo/groups/tDCStim/conversations/messages
The foc.us device does tDCS, and also does tACS, tPCS (which may be more effective than tDCS) and tRNS.
Posted by SLS on December 11, 2015, at 12:43:46
In reply to Re: Recruiting TRD patients for LFMS study » SLS, posted by Hugh on December 11, 2015, at 11:39:15
Thank you!
> This Yahoo group is a good place to learn about tDCS. There hasn't been any new activity in months, but the archives and files contain a lot of valuable information.
>
> https://groups.yahoo.com/neo/groups/tDCStim/conversations/messages
>
> The foc.us device does tDCS, and also does tACS, tPCS (which may be more effective than tDCS) and tRNS.
>
> http://www.foc.us/?s=blog.html
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