New Hope for Teens with Depression
Researchers at the Alberta Children’s Hospital Research Institute are one step closer to getting non-invasive brain stimulation approved as a new treatment for teen depression across North America. If successful, it would be the first new therapy made available to families in more than a decade. Calgary researchers are working with specialists from the Mayo Clinic and sites across the continent on a clinical trial that could pave the way for Food and Drug Administration (FDA) to make brain stimulation a standardized treatment in youth with depression. “This trial is the final hurdle in establishing a different therapy option for adolescent depression,” says Dr. Frank MacMaster, who is helping lead the study. “Having a new treatment on the table will be a game changer for young people and their families who face challenges that currently seem insurmountable.” Participant recruitment is set to begin in January.
A team at the hospital led by Dr. MacMaster and Dr. Adam Kirton has been studying the effects of Transcranial Magnetic Stimulation (TMS) in teens who have not responded to conventional treatment options, such as drugs and behavioural therapy. TMS alters the level of activity in a section of the brain called the dorsal lateral prefrontal cortex, which regulates emotion, attention span and the ability to organize, plan and function as a responsible, productive adult. This stimulation is done using a magnetic field and is pre-mapped by a 3T MRI.
“Essentially, TMS helps re-wire the boss of the brain,” says Dr. MacMaster. “This is a non-invasive way to make it work more effectively in order to control the symptoms of depression.” Relative to long-term and multiple-medication regimes or leaving depression untreated, TMS is a significantly lower risk option, he adds.
The results of the research have been incredibly positive so far. More than three quarters of participants have responded to treatment and more than half have had their symptoms reduced by over 50%. That success drew the attention of experts at the Mayo Clinic, who approached Dr. MacMaster’s group in hopes of collaborating. Twelve hospitals across North America are now gearing up for a multi-site clinical trial. The Alberta Children’s Hospital is the only Canadian participant.
Recruiting for the randomized control study, which will involve about 100 youths aged 12-21, will begin in January 2016. The study is the final hurdle in making TMS a standardized therapy for teens with depression. Ultimately, it could become the frontline go-to treatment, says Dr. MacMaster, adding there is already concurrent work underway here in Calgary to identify biological predictors of TMS response rates in teens with depression. As well, there are many possibilities down the road, including developing TMS treatment for other brain disorders ranging from autism to schizophrenia, he says.
Plus, it would have come to market in a span of just seven years, which is incredibly fast in comparison with new drugs, which can take up to three decades to move from conception to implementation as a treatment, says Dr. MacMaster.
Dr. MacMaster is very grateful for the community support that helped propel his team to this stage. Donations funded the creation of the TMS lab – the only one in Canada for children – as well as the innovative TMS pilot project that led to the clinical trial about to begin. “This would not have happened without community investment,” he says. “Thanks to that support, we were able to run a very successful pilot project that led to this exciting last step in making TMS a standardized treatment for teens in need.”
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