Question:
Have you seen good results with Transcranial Magnetic Stimulation therapy for Depression and Anxiety?
Answer:
Transcranial magnetic stimulation (TMS; also called repetitive transcranial magnetic stimulation) is a form of brain stimulation therapy. Other brain stimulation therapies include electroconvulsive therapy (ECT), vagus nerve stimulation (VNS), magnetic seizure therapy (MST), and deep brain stimulation (DBS). These procedures stimulate the brain with electricity through electrodes planted in the brain, through electrodes on the scalp, or through magnets placed on the head. ECT and TMS are therapies used more commonly for treating mental illness. For ECT, electricity is delivered via electrodes on the scalp. For TMS, the brain is stimulated with an electromagnetic coil. Depending on the brain stimulation method, they might be used for depression, catatonia, anxiety, psychoses, bipolar disorder, and others. Frequently, they are used only if the condition does not respond to other treatments (such as medications or therapy).
I have no experience with TMS in patients with Down syndrome (DS) who we have seen at the Adult Down Syndrome Center. I am aware of one person with DS who has catatonia and regression who is reported to have had significant benefit from TMS. We have had experience with ECT for several of our patients with catatonia and regression and have had positive results. Considering their positive experiences, I have recommended to some other families who did not want to pursue ECT for their family member with DS who has catatonia and regression that they consider TMS. We do not have TMS at our hospital, so I have referred these families to a site in our area that provides TMS. To date, the families have decided not to pursue TMS. I am personally not aware of individuals with DS for whom these treatments have been used for other indications (other than catatonia) such as persistent depression. We were not able to find articles in the medical literature describing the use of TMS or its effectiveness in people with DS.
Dr. Judith Miles and her colleagues reported on 7 individuals with DS and catatonia in the article linked here. The treatment for some of the individuals included ECT. A helpful review of brain stimulation therapies by the National Institute of Mental Health is available here.