Brain stimulation therapies for

mental illness

A media webinar co-hosted by the Science Media Centre of Canada

 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

 How rTMS became a useful therapy
for 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
Current rTMS research on suicidality
 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
Temerty Centre for Therapeutic Brain
Intervention at CAMH
 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

 Gail Bellissimo

rTMS is allowing me to thrive,

not just survive.
 tDCS for Alzheimers 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
 Who could benefit from tDCS?

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 Alzheimers disease could have

a huge impact on reducing the burden of illness
tDCS kit
 Current study: PACt-MD

Preventing Alzheimers and dementia with Cognitive remediation

plust tDCS in MCI and Depression

target population is older adults at high risk of Alzheimers 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
 PACt-MD
Preventing Contact:
Alzheimers dementia Sara Gambino
with Research Analyst
Cognitive remediation CAMH
plus 416-535-8501
tDCS in ext. 33657
MCI and
Depression