When treating brain disorders, you don't immediately think of magnets. Nevertheless, magnetic properties can be used to influence the functioning of the brain. Debby Klooster, researcher at Ghent University, investigated which patients would benefit from this.
At least one in four people develop a brain disorder in their lifetime. Our brain is the most complex organ in the body. Practically everything we do is controlled by our brain — movements, memory, consciousness and emotions, as well as unconscious functions such as breathing, blood pressure and body temperature. The complexity of the brain is on one hand an advantage, because we can perform many different functions and tasks with it. On the other hand, many things can go wrong because of this complexity.
If parts of the brain are too much or too little active or if different regions do not communicate well with each other, a brain disorder such as depression can develop. Initially, brain disorders are treated with medication. However, medication does not help all patients. In the specific case of depression, medication only helps 30 percent. Alternative treatment methods are therefore necessary.
In his research Klooster looked at the effect of such an alternative treatment method — namely transcranial magnetic stimulation (TMS). TMS is a method based on electromagnetic induction. So what is electromagnetic induction? Electromagnetic induction means that a changing magnetic field generates an electric current and vice versa. This sounds quite complicated, but in practice it comes down to generating small currents in the outer layers of the brain. For this a coil is used that is placed on the head of the patient. Those small currents can influence the functioning of the brain and in this way they try to make sick, abnormal brains better.
TMS is currently already an approved treatment method for depression. I can hear you thinking — what still needs to be investigated? The problem with the treatment is that there are huge differences in the effects of the treatment. It definitely benefits some patients, while it doesn't help at all for others. In the research, Klooster showed that patient-specific brain characteristics can provide us with information about how a patient will respond to a treatment. Brains have unique properties that can vary from person to person such as size, shape, activity in different regions and the number of connections between them.
Looking Into the Brain
To map these patient-specific characteristics, neuroscientists use an advanced imaging technique — magnetic resonance imaging, or MRI. An MRI scanner can create images of the inside of the brain. Depending on the settings of the scanner, we can visualize different properties, for example which tissue types are located where, which parts of the brain are active while performing certain functions or during rest and which connections are present in the brain.
With an MRI scanner, various characteristics of the brain can be mapped. From left to right we see the anatomy of the brain, the activity in the brain (red: a lot of activation, blue: little), and the nerves in the brain (color coding indicates the direction of the nerves, blue = up-down, green = front-back, red = left-right).
For my research I used all these types of MRI data. Measured in a group of fifty depression patients, all were treated with TMS. We measured MRI data from all these patients before and after the treatments. In addition to MRI data, we also closely monitored the clinical well-being of the patients using questionnaires.
— Debby Klooster
According to Klooster, this extensive dataset gave them the opportunity to investigate many different aspects of TMS. They mainly looked at whether patient-specific characteristics, measured before treatment, could predict the clinical effect of the treatment. They found that both brain activity and brain connections can be linked to the clinical effects of the treatment. This important finding could be further researched in the future and developed into guidelines that can indicate prior to treatment whether or not a patient's clinical picture will improve after TMS treatment.
Personal Treatment Plans
We have shown that patient-specific characteristics derived from MRI images can predict the effect of stimulation. That finding allows us to personalize TMS treatments (recently published in Cognitive Neuroscience and Neuroimaging). This means that for each treatment we map out the patient-specific characteristics of the brain using imaging techniques and adjust the precise TMS treatment accordingly. We suspect that these personalized treatments can lead to better results and a higher effectiveness of the TMS treatments.
More research is needed to confirm this suspicion. In this way we can ensure that in the future more people, with various brain disorders, will benefit from a TMS treatment.
© 2022 Hamza Hussaini