Epworth Centre for Innovation in Mental Health

During this episode of the Life Matters podcast, Prof. Paul Fitzgerald sits down and speaks with Host, Michael Mackenzie to discuss the role of Transcranial Alternating Current Stimulation in treating depression.

The pressures of isolation, joblessness, and uncertainty during the pandemic have already seen an upsurge in rates of depression and anxiety.

Common treatments include therapy and medication, but what if there was a third arrow in this quiver?

https://www.abc.net.au/radionational/programs/lifematters/how-transcranial-magnetic-stimulation-could-be-a-game-changer/12338262

How Transcranial Alternating Current Stimulation could be a game changer in treating depression The nation's mental health is under strain. The most common treatments include therapy and medication, but what if there was a third arrow in this quiver?

Brain stimulation can be personalised to suit to each individual’s personal threshold, or the amount of stimulation it takes for their neurons to fire. This is called the Resting Motor Threshold (RMT)

RMT is the minimum intensity required to produce a motor evoked response while at rest.

How do you obtain RMT?

Apply TMS to the Primary Motor Cortex (hand strip),is located left of centre along the back of the head. As this brain region controls the hand, we can visually observe reactions to TMS. As we increase the stimulation intensity, we can observe increased muscle reactions, such as muscle twitches in the hand.

Even just tiny muscle twitches in the hand can indicate that we have reached a person’s RMT, the minimal intensity required to elicit a response.

Watch this video below to observe RMT in action.

https://www.youtube.com/watch?v=BxahseiYV5A

RMT short Demonstration This video demonstrates how to achieve Resting Motor Threshold (RMT) using Transcranial Magnetic Stimulation (TMS)

‘My Year of Living Mindfully’ is documentary film with international cinematic release incorporating interviews with Dr Neil Bailey, expert on the neuroscience of mindfulness.

Dr Neil Bailey is a Senior Research Fellow and neuroscience and meditation expert at ECIMH. His research focuses on the use of brain stimulation and EEG to explore neural activity in healthy individuals, depression, and individuals experienced with meditation.

Neil has over 50 publications in leading neuroscience journals and has over 7 years of experience in the use of brain stimulation techniques.

You can watch the film here.
https://www.myyearoflivingmindfully.com/

My Year Of Living Mindfully From the director of the internationally acclaimed documentary of the same name, MY YEAR OF LIVING MINDFULLY is a book filled with compelling stories, groundbreaking science, and unexpected insights that go to the heart of what it means to be human in the twenty-first century.

Meet the Deputy Director of ECIMH.

Professor Kate Hoy is a Clinical Neuropsychologist, Head of Interventional Neuropsychology, and Deputy Director at ECIMH. Professor Hoy runs a substantive research program focused on developing novel biological treatments for cognitive disorders.

She is internationally known for her research investigating non-invasive brain stimulation in the treatment of cognitive impairment, and has worked in brain stimulation research for over 15 years.

Kate is also a passionate and active science advocate, particularly around issues of equity, diversity and inclusion and career sustainability. She currently works with the Australian Academy of Science across a number of national diversity and inclusion initiatives. In 2016 she founded the WomeninBrainStim.com initiative, a database website which has had a positive impact in addressing the extreme gender imbalances at international brain stimulation conferences, as highlighted in Science Careers.

Electroencephalography (EEG) refers to a method of measuring brain activity using a special cap with electrodes that measures changes in the electrical potentials of brain cells on the surface of the brain.

EEG can be used to examine whether there has been changes brain activity following brain stimulation treatment.

For example, gamma waves are related to memory formation and retrieval. Changes in gamma frequency activity may be contributing to the cognitive changes observed in Alzheimer’s disease. EEG could therefore be used to measure changes in gamma waves following treatment that aims to restore gamma activity to see if it has done what it set out to do.

Prof. Kate Hoy continues to focus on innovative treatments for people with disorders of cognition. Channel 9 reported on Professor Hoy’s clinical trial investigating transcranial magnetic stimulation for the treatment of mild to moderate Alzheimer’s disease, which has just concluded recruitment.

“This grandmother had a 6-week course of magnetic stimulation known as TMS. Patients are awake for the procedure which takes minutes.”

“Neuroscientists say that TMS is not a cure, but hope it may slow some of the mental decline experienced by sufferers.”

Watch the full report below.

https://www.9news.com.au/health/magnetic-therapy-helping-clear-the-minds-of-alzheimers-patients/7f25cdbe-c753-4cbc-8e57-81284c3982ee

VIDEO: Magnetic therapy helping clear the minds of Alzheimer’s patients A new treatment for Alzheimer’s disease, which uses magnetic energy to manipulate the brain, is being...

Recently, a form of brain stimulation known as transcranial magnetic stimulation (TMS) was placed on the Medicare listing as a treatment for depression. 🧠

What does this mean?

Medicare listing refers to a list of the medical services subsidised by the Australian Government. This significantly reduces associated fees enabling everyday Australians to access treatments at a more affordable price..

How did this happen?

For the past 20 years, the Director of ECIMH Professor Paul Fitzgerald has dedicated his research to developing new treatment options for people diagnosed with depression. This includes conducting clinical trials of TMS with involving hundreds of people with depression to find the best way to deliver it, and leading the successful application which resulted in the Medicare listing of TMS for the treatment of depression.

Mental health research has evolved significantly over time and this remarkable outcome serves as a reminder than anything is possible with persistence.

Meet the Director of ECIMH.

Prof Paul Fitzgerald is a consultant psychiatrist and Professor of Psychiatry at Epworth HealthCare and Director of ECIMH, Monash University.

He has been innovating psychiatry research for over 20 years, with over 450 peer reviewed publications. He developed and leads the world's largest program investigating the use of non-invasive brain stimulation and other novel therapies in the treatment of depression, bipolar disorder, schizophrenia and a number of other conditions.

He led the successful application to Medicare for the public funding for TMS as a treatment for depression in Australia, and continues to advocate for access for those who need it most.

There are two main approaches to treat depression; medication and psychological interventions.

Until now a third option being investigated as a treatment, non-invasive electrical therapy, could only be conducted inside a clinic. Our You-tACS study of home-based remote treatment is hoping to change that.

SBS The Feed filmed a short documentary about our at-home electrical therapy for depression clinical trial at ECIMH, talking to past participants about their experiences.

The approach is called Transcranial Alternating Current Stimulation (tACS), and it is part of a trial run by Paul Fitzgerald at the Epworth Centre for Innovation and Mental Health.

Prof Fitzgerald believes it could be a "game-changing intervention" for depression that could dramatically lower the cost and increase access to patients.

"This is the first trial really anywhere in the world that has adopted the fully personalised approach that we use; we individualised the frequency based on each individual's own brain activity," said Prof Fitzgerald.

"What we're really trying to do is to tap into the intrinsic language of the brain and apply stimulation at a frequency that interacts with the brain and causes subtle changes over time in those brainwaves to achieve therapeutic benefits," said Prof Fitzgerald.



https://www.rrr.org.au/explore/podcasts/einstein-a-go-go/episodes/5196-venus-depression-treatment-and-july-lectures

Podcasts: Venus, Depression treatment and July lectures, Einstein A Go-Go — Triple R 102.7FM, Melbourne Independent Radio Astrophysicist Dr Rebecca Allen from Swinburne University, talks about the new NASA missions to Venus; Kate Gunningham from Epworth Centre for Innovation, discusses her work in a trial investigating a novel non-invasive brain…

What is transcranial magnetic stimulation (TMS)? 🧠

TMS is a form of non-invasive brain stimulation that uses a magnetic pulse to cause brain cells in a specific region of the brain to fire. We place a coil on the head to apply the stimulation. The magnetic pulse passes freely into the brain and an electrical current is induced perpendicular to the magnetic field. This electrical field causes brain cells to fire.

In other words, the magnetic pulse can increase or decrease brain activity, which can lead to changes in mood, behaviour, and thinking.

TMS has significant potential to help us understand of the brain, and as a treatment for a range of conditions.

At ECIMH, we have used TMS to treat a range of symptoms for depression, OCD, schizophrenia, fibromyalgia, anxiety, and Alzheimer’s disease.

“I didn’t like that there were no effective ways to treat cognition in disorders like Alzheimer’s disease and schizophrenia, and so I decided to change it.”

Find out how Prof. Kate Hoy from ECIMH is looking to improve the lives of people with Alzheimer’s, with the help of brain stimulation. 🧠

https://www.youtube.com/watch?v=nSnEW2KJsVQ

Agent of Change - Kate Hoy, Monash Medicine, Nursing and Health Sciences - Cognitive Disorders Find out how Kate is looking to improve the lives of people with Alzheimer’s, with the help of magnetic pulse.https://change-it.monash.eduhttps://www.monash....

There is a growing need for alternative treatment options for mental health and brain disorders to traditional medications which can take 11 to 18 years to develop.

Although medication can be beneficial, it is not always effective at helping to improve symptoms. Currently, approximately 30% of people do not respond to medication for depression. For some disorders, there are no effective drug treatments.

So, what is the alternative?

Brain stimulation provides a treatment alternative that directly targets brain regions in a non-invasive way. It has fewer potential side effects, and has been shown to be effective for a number of different conditions, such as depression.

It also only takes 4.5 to 10.5 years to develop and approve medical devices, compared to 11 to 18 years for medication!

Brain stimulation helps to offer more treatment options, for many disorders, which is why brain stimulation is a major focus of research at ECIMH.

In this episode of Psych Matters, Dr Salam Hussain and Professor Paul Fitzgerald discuss Transcranial Magnetic Stimulation (TMS).

https://psychmatters.ranzcp.org/1072258/8331987-transcranial-magnetic-stimulation-tms

Speakers: Professor Paul Fitzgerald

Paul Fitzgerald is Professor of Psychiatry at Monash University and Director of the Epworth Centre for Innovation in Mental Health based at Epworth Camberwell. He is a qualified psychiatrist, has a Masters of Psychological Medicine and research PhD.

His main clinical and academic interest is in the development, evaluation and clinical translation of new therapies for mental health conditions. He has conducted over 20 clinical trials in depression, schizophrenia, obsessive compulsive disorder, PTSD, autism and Alzheimer’s disease along with over 50 experimental studies. He has established multiple clinical TMS services, is a founder and board member of TMS Clinics Australia, and established Australia’s first TMS clinical training program.
Paul Fitzgerald has had continual NHMRC grant support for almost 20 years and over $20 million in research support in the last 5 years.

Our mission is to transform outcomes for people with disorders of mental health and brain function by developing, advancing and translating brain stimulation and other innovative therapies.

How?

Stage 1: Researchers at ECIMH use neuroscience techniques to identify therapeutic targets that we can modulate in order to improve symptoms of brain-based disorders.

Stage 2: We then investigate how different types of brain stimulation impacts brain activity so we can select the most appropriate approach to be able to modulate an identified therapeutic target.

As part of the final stage of this process (Stage 3), we then move on to starting and running clinical trials with participants to investigate efficacy of possible interventions based on information gathers during Stage 1 and Stage 2 in pursuit of our mission.

By understanding how brain stimulation impacts human brain function and behaviour, we can better understand various disorders and how to treat them.

For example, if increased brain activity in a certain brain region following brain stimulation can improve memory capabilities, then this may inform treatment development to improve memory for people who have experienced memory decline.

This is currently our focus as part of our Dementia research in the Interventional Neuropsychology Department at ECIMH. 🧠