Saturday, December 03, 2022

How electrical engineers designed groundbreaking treatment for depression

“In a nutshell, the key innovation here is the novel image processing algorithms that we’ve developed to process the brain scans, which we can then use to reduce the time the patient spends in the scanner. Therefore, it makes it more comfortable for the patient and it makes personalization of the therapy feasible.”

The procedure, which is being trialled clinically in the Queensland Neurostimulation Centre, also makes use of a TMS robot to deliver their innovation of determining the optimal coordinate for treatment.

“A coil delivers the stimulation to that precise point to the patient and if the patient moves their head during the treatment, the robot will then adjust the coil to compensate for that movement,” Zalesky said.

“That way, we can be sure that therapeutic magnetic stimulation is delivered to the precise coordinate at all times.”

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Atlas of the human subcortex. Connections between several subcortical regions, particularly the limbic system, and the frontal cortex are altered in people with depression.

Engineering better therapeutics

Zalesky works in systems neuropsychiatry, which focuses on understanding the brain as a whole through the relations between particular regions, and how communication and interactions occur between those different parts.

“We’ve moved from a reductionist approach where we’re focused on trying to understand the function of a specific region to a systems approach,” he said. “The importance of that is that we know now that many neuropsychiatric and neurological disorders are actually disorders of altered brain connectivity.

“For example, schizophrenia is associated with dysfunction and disruption to communication between multiple brain regions, particularly frontal and subcortical circuits. Similarly, with depression, neural circuits linking the limbic system with the frontal cortex show evidence of dysfunction, and we believe that altered interactions between these brain regions may in part result in the symptoms of depression.”

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Disrupted brain network associated with schizophrenia.

The technology was recently approved by the Therapeutic Goods Administration in Australia, and has been licensed to the Queensland Neurostimulation Clinic. Around 30 patients have been treated to date.

“While a full clinical trial is needed to establish efficacy, most patients have reported excellent outcomes,” Zalesky said.

Some individuals will have one course of treatment, and other individuals will require maintenance treatments every 6 to 12 months. But the researchers hope that their optimized approach will result in longer efficacy.

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