Helmet for treating depression being used in Austin

Deep TMS has been FDA-approved to treat major depressive disorder

Danny Pyka, an Austinite who worked for Mercedes-Benz for about 10 years, had been suffering from depression for so long and so severely that he was certain his suicidal thoughts would eventually lead to the end of his life.

"It was just miserable," said Pyka, who found work as a handyman, but found it difficult to have a normal life or relationships with his wife and 18-year-old daughter not affected by his condition. "I was secluding myself... I'd close the house off and just sleep pretty much the whole day."

Many attempts at medicating the problem over 10 to 15 years failed. He heard through a friend that studies were being done on a new technology, Deep TMS, or Deep Transcranial Magnetic Stimulation, from a New Jersey and Tel Aviv-based company called Brainsway. Pyka was able to get the treatment in Austin and says he noticed an improvement after the first week of about nine weeks of treatments.

"The suicidal thoughts were ruminating thoughts that affected me throughout my daily life. After the first week and so on, they just dissipated. I'm very fortunate and very happy that it worked for me," Pyka said.

Credit: Contributed by Brainsway Ltd.

Credit: Contributed by Brainsway Ltd.

Pyka had the treatment done at Senior Adults Speciality Healthcare in Northwest Austin, which has been working with TMS technology for about two and a half years. TMS works through a mounted helmet that generates an electrical pulse, not unlike the technology in an MRI. Patients cycle through two-second pulses followed by 20 seconds of rest for each sequence, called a "Train," and it's repeated for about 20 minutes. Treatments are done daily for about six weeks, followed by a three week tapering off period.

Different patients may require a different power intensity depending on each patient's motor threshold, the number of sequences is the same for all patience. The pulses for this particular treatment (there are others being tested for other afflictions) target the primary motor cortex. The low-level electrical charge affects mood regulation, retraining the nervous system to work correctly.

Dr. Jaron Winston says that unlike electroconvulsive treatment, or shock treatment, which can have severe side effects, TMS has proven for many of his patients to be the a less invasive treatment for chronic depression that works more effectively than medication.

"About 60 percent of patients (within our clinic) go into total remission of their depression; 60 to 70 percent had significant reduction of depressive symptoms," Winston said.

Clinical studies of the technology since its FDA approval for treating depression in 2008 have bolstered the view that it can be effective for some who have not gotten results from medication or for those who've relapsed into depression,.

The National Institute of Mental Health has funded studies into the technology, which lists it on its website alongside electroconsulsive therapy. The American Psychiatric Association includes TMS in its 2010 guidelines for treating major depressive disorders  and the organization says it will be updating those guidelines soon with more recent research.

Winston said that patients can experience some minor pain from the pulse as nerves on the scalp are stimulated, but that it typically goes away, which Pyka said was his experience.

"It feels like somebody thumping on the right side of your head for the amount of seconds" the machine runs, Pyka said. But by the third or fourth treatment, he said, "it gets more simple to do. I’ve honestly nodded off a couple of times in the chair. You get used to it."

In the U.S., Deep TMS is only FDA-approved for use in treating depression, and Winston says that insurance typically won't cover followup maintenance appointments or the treatment itself unless medications have used and failed to treat the depression.

Off-label treatments being tested using other versions of the technology could help treat post-traumatic stress disorder, obsessive-compulsive disorder, bipolar depression and even smoking addiction by stimulating other parts of the brain.

Winston said that many potential patients and even some doctors and psychiatrists are unaware that the technology exists and is available, particularly for people who aren't responding to medication.

"It's another treatment to help make (patients) functional again, to make them come out of their depression and withdrawal states," Winston said. "As treatment goes by, they will say they've never felt this well, their thinking is clearer, their cognition is better, than can focus, their mood is better, sleep is better. But there's still people who don't know anything about it."

Pyka, who has completed treatment with Deep TMS, says he's been more productive and is now able to enjoy watching his daughter grow up without taking five or six medications a day (he only takes medication for sleep issues now).

The crying and worrying, he says, has subsided.

"It's been a life-changing experience."