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Friday, November 1, 2013
Transcranial Magnetic Stimulation (TMS) May Reduce Depression, Fatigue in MS Patients
COPENHAGEN, Denmark — Deep repetitive transcranial magnetic stimulation (TMS) of the motor cortex has the potential to reduce fatigue and depression in patients with multiple sclerosis (MS), a new study suggests.
The study was presented by Sven Schippling, University Medical Centre, Zurich, Switzerland, at the recent 29th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS).
He explained to Medscape Medical News that TMS is a noninvasive, safe technique for stimulation of brain regions that has been shown to be effective in major depression, autism, and schizophrenia but has not been investigated previously for fatigue and depression in MS. He noted that fatigue and depression are frequent symptoms in patients with MS, with two thirds of patients reporting fatigue as their most disabling symptom and depression occurring in more than half of patients.
Dr. Schippling and colleagues tested the TMS strategy on 2 different areas of the brain: the prefrontal cortex and the motor cortex. "We thought the prefrontal cortex would be the best area to target as it is more involved in depression, but to our surprise it turned out that the results for the motor cortex area were much better," Dr. Schippling commented.
He cautioned that this was a preliminary phase 1/2 study with small patient numbers, so any conclusions must be speculative but that the impressive results in the motor cortex group may be explained by easing the demands on that part of the brain when carrying out basic tasks.
"We know in MS patients, even from the earliest stages of the disease, recruit a much broader area of the brain than patients without the disease to achieve just a simple motor task," he said. "Giving exogenous stimulation to the key areas involved in motor tasks could reduce the area of the brain being taxed, so sparing energy."