New form of magnetic brain stimulation spells hope for patients with treatment-resistant depression – The Straits Times

SINGAPORE In a first for South-east Asia, Singapore researchers are studying a personalised form of magnetic brain stimulation that can potentially help more people with treatment-resistant depression.

It involves mapping a persons brain using scans to locate a precise spot to target during the stimulation.

In Transcranial Magnetic Stimulation (TMS), which is already offered in Singapore, doctors stimulate a spot that is connected to a deep part of the brain that has been consistently implicated in depression.

Standard TMS, which is done without the brain-mapping, offers those diagnosed with treatment-resistant depression around a 30 per cent chance of getting well enough to not qualify for a depression diagnosis.

It delivers stimulation to the same spot of the brain for all patients.

As the layout and location of the brain networks are different for each person, the personalised version uses functional magnetic resonance imaging (fMRI) to pinpoint the exact spot unique to each patient, and stimulate it to treat their depression disorder as accurately as possible.

An artificial intelligence algorithm is used to clearly outline individual brain networks from the fMRI data, said Associate Professor Thomas Yeo, a brain scientist who is from the Centre for Sleep and Cognition at the Yong Loo Lin School Of Medicine at the National University of Singapore (NUS Medicine) and the co-principal investigator for the trials.

A high-precision robot arm is also used to target the stimulation.

The personalised TMS treatments are more intensive than the standard procedure 50 sessions are conducted over five days, instead of a minimum of 30 sessions over 30 days. Each personalised TMS session is 10 minutes long, while a standard TMS session can be 30 to 60 minutes long.

The Institute of Mental Health (IMH) is collaborating with NUS Medicine for two concurrent trials on personalised TMS, funded by separate parties. The trials started in March 2024 and will last for three years. The two trials will recruit a total of 90 patients, of whom 55 will undergo personalised TMS while the rest will be assigned to standard TMS.

Singapore is the first country in South-east Asia to conduct the clinical trials of personalised TMS, which is modelled after the personalised TMS approved for use in the US, known as the Stanford Accelerated Intelligent Neuromodulation Therapy protocol.

In the US (study), about 80 to 90 per cent of the patients get well with personalised TMS after one week. We will see whether it works in Asia, said Dr Tor Phern Chern, a senior consultant at the Mood and Anxiety department and Head of Neurostimulation Service at IMH, at a media briefing on April 12.

Dr Tor said that one day of 10 personalised TMS sessions is equivalent to six weeks of standard TMS, so it is like getting 7 months of TMS in five days. Whether this removes the need for individualisation is a question that one of the trials will attempt to answer.

Trial participants do not have to pay for the treatment. Temasek Foundation and the National Medical Research Council are funding the trials, each with a grant of $1 million.

Read more:

New form of magnetic brain stimulation spells hope for patients with treatment-resistant depression - The Straits Times