Magnetic Brain - Catalyst
Narration: Richard Stroud is bipolar. It’s a disorder which
brings with it serious depression that is ruining his life. He’d all but
given up hope of improvement before discovering this amazing experimental treatment.Pulsing
magnetic fields are being used to try and change the way he feels.
Richard Stroud (patient): This is most important to me. I mean I‘ve dropped
everything in my life… so I’m looking at this as close to a last chance
effort of getting well.
Narration: News of this treatment has attracted patients from around Australia
and from overseas. Richard Stroud has come to Melbourne all the way from his home
in LA. An imaginative entrepreneur, he’d built a business turning over 10
million dollars a year. But the business crashed as the demons of depression took
hold in his mind.
Richard Stroud: Your most important asset, your mind, instead of being your
friend and your consort, suddenly becomes your enemy, and since it’s with
you 24 hours a day, you have an enemy with you that knows everything about you
working against you 24 hours a day. It’s a very intolerable position if
you will.
Narration: Richard tried almost every imaginable treatment– endless combinations
of drugs, and psychological counselling. But his depression became so severe it
nearly claimed his life.
Richard Stroud: It comes to your mind that the only way that you would possibly
stop it would be to be no longer. All you have to do to die is to stop trying
and pretty soon you’ll die.
Narration: This is one therapy Richard has intentionally avoided. - Electroconvulsive
Therapy, or ECT. For 60 years it’s been the last resort for people suffering
severe depression. While ECT helps many patients, it does have serious disadvantages.
It requires a general anaesthetic, which always carries a risk. And many potential
patients are frightened away by the common side effect of memory loss.
Dr Paul Fitzgerald, Psychiatrist: ECT - it does have a tendency to produce
problems with people with memory. In general most of those problems go away over
time and are short-lasting, but there can be some lasting effects and people get
very distressed by change in their memory.
Narration: Psychiatrist Paul Fitzgerald thinks he has an alternative to ECT.
It’s called Transcranial Magnetic Stimulation or TMS. It has been tried
before without much success, and most doctors still doubt it works. But now Paul
and his team here at the Alfred Hospital in Melbourne think they’ve cracked
the TMS puzzle.
Dr Paul Fitzgerald: I started out, particularly in this area, quite sceptical
about how effective the TMS would be in depression. I have become convinced now
that it works - now its really about developing into a tool that is highly clinically
useful.
Narration: Richard is about to have his first treatment. The figure eight shaped
magnet produces a short, intense magnetic pulse. Like the much older ECT, no-one
knows exactly how TMS can change a persons feelings, but Paul has a theory.
Dr Paul Fitzgerald: Ee think in general that what happens is the magnetic pulses
actually induce the nerves in the brain to fire. Like they would normally when
the brain is active, but to make a large plastical groups of nerves fire at the
same time. And by making the nerve cells fire repeatedly we gradually change their
properties. By that I mean we can gradually make those nerve cells more likely
to fire or less likely to fire in the future.
Narration: That’s important because depressed people have an imbalance
in the activity on the two sides of their brain. But by getting the intensity
and frequency of the magnetic pulses right, Fitzgerald believes you can ‘re-balance’
nerve cell activity.
Dr Paul Fitzgerald: We’ve got a type of TMS that increases brain activity,
and we target that on the left side of the brain to try and make the left side
more active. And we also have an approach that reduced brain activity, so we target
that on the right side of the brain.
Narration: Throughout the 10 minute process Richard remains conscious and in
relative comfort.
Richard Stroud: It felt like someone was tapping on the top of my head with
a pencil maybe. I was more interested in whether this thing was going to hurt
or not and it doesn’t.
Narration: It’s now four weeks since Richard began his daily TMS treatments.
It’s time to take a look inside his head and see if things have changed.
While his brain is being scanned, Richard solves a series of puzzles that activate
his frontal cortex - the imbalanced area of the brain linked with depression.
Dr Paul Fitzgerald: So these are the scans, which he's had before and after
his treatment. So on this scan what you see is the area of activation in the brain
that's produced when he's doing those puzzles in the scanner. So he's thinking
its activating areas in both his right and his left pre frontal cortex.
Narration: Before treatment Richard was using a large area at the front of
his brain. But after TMS the scan reveals a dramatic decrease in the area of brain
needed to solve puzzles.
Dr Paul Fitzgerald: After treatment it's significantly reduced. What this suggests
is that when he reports feeling better there is concrete evidence from his brain
that the TMS results in a reduction in activity in that area of the brain. How
that relates directly to him feeling better is something we need to nut out, and
we want to see that across multiple patients. But it's certainly very supportive
of what we think's going on.
Narration: And even better news is the patients themselves feel. All the participants
had failed to respond to both drug and psychological therapy, but TMS has enabled
almost half of them to recover from depression.
Dr Paul Fitzgerald: It’s really been the response of our patients that
convinces us that it is an endeavour worth pursuing. We’ve certainly got
no doubt now that TMS works. It’s really a matter now of refining treatment
and ensuring we’re able to deliver it in an effective way for the greatest
number of patients.
Narration: There’s still a way to go before TMS becomes commonplace.
Big companies have been unwilling to invest in treatment that can’t be patented.
But if Richard’s experience is any guide, the long term future of TMS is
assured. He’s emerged from his depression, revitalised and re-invigorated.
Richard Stroud: I’m alive again, its marvellous. And its going to get
better I can feel its going to get better. This stuff is working. Thank God it’s
working!
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