Authors: Marilyn McMurchie, Roger Gurr, Donel Martin, Jason Pace, Perminder Sachdev
Year: 2017
Event: 2017 TheMHS Conference
Subject: symposium, technology, innovation, treatment
Type of resource: Conference Presentations and Papers
Abstract: Technological innovations are increasingly used in mental health management and are moving into mainstream clinical services especially for people with problems refractory to the usual interventions. Evidence is building for effectiveness and acceptance. These technologies are used in conjunction with medication (and sometimes as a replacement for it) which is particularly helpful to people who find the medications don’t work for them or make them physically unwell. ECT (Electro Convulsive Therapy) has been used for many years to treat depression and recently changes in the way it is administered have been delivering good results with less of the unpleasant effects such as temporary memory loss. Transcranial Magnetic Stimulation (TMS) is a relatively new technique which is non-invasive and uses magnetic fields to stimulate the underlying brain. Biofeedback through focused EEG allows the person being treated to learn how to manage anxiety and unpleasant thoughts by being able to see changes in the brain as a result of their thoughts. Deep brain stimulation has been shown to be a viable option for some people who have depression. A doctor implants tiny electrodes in the part of the brain that regulates mood and then electrical stimulation in delivered which stimulates the mood area.
The symposium will explore each of these technologies and current results in their use. There will be time to discuss the merits and effects of these technologies with the experts who use them.
Names of speakers & topic of their talk
1. Marilyn McMurchie (chair): Introduction
2. Roger Gurr: Quantitative EEG and Neurofeedback
3. Donel Martin: Transcranial Direct Current Stimulation (tDCS): A Novel Therapeutic Treatment
4. Jason Pace: Transcranial Magnetic Stimulation (TMS ) - A real alternative for Major Depression Disorder
5. Perminder Sachev: Deep Brain Stimulation (DBS) for Neuropsychiatric Disorders: The Current Status
Topic Abstract 1: Roger Gurr
Advances in technology are leading to an exponential growth in knowledge about brain structure and function. New methods of dynamic image creation, through computer processing of massive amounts of data, has enabled exploration of neural pathways and specific brain functions. Some biomarkers for mental health disorders are emerging. In turn this is enabling exploration of new treatments through influencing brain function by low voltage direct electrical current, electromagnetic stimulation and brain training through positive neurofeedback. Through functional molecular resonance imaging (fMRI) and quantitative electroencephalography (QEEG) we can measure brain changes due to psychological trauma and see the brain function return towards normal with neurofeedback and therapies such as eye movement desensitisation and reprograming (EMDR). The presentation will report on this progress and discuss future possibilities.
Topic Abstract 2: Donel Martin
Transcranial direct current stimulation (tDCS) involves the application of a small electrical current to the brain to modulate neuronal functioning. Over the last two decades tDCS has emerged as promising novel therapy for several psychiatric and neurological conditions (e.g., depression) and has attracted widespread attention due to its excellent translation potential as a result of safety, portability and low cost. An overview of the therapeutic effects of tDCS will be provided, in addition to the challenges which need to be overcome prior to tDCS becoming accepted as a frontline treatment.
Topic Abstract 3: Jason Pace
Dr Jason Pace is a private psychiatrist who established Sydney TMS an outpatient TMS clinic service in late 2015. The presentation will outline his clinical journey with TMS and summarise where he sees TMS sitting on his treatment algorithm for treating Major Depressive Disorder. He will discuss patient selection, tolerability, effectiveness and the future of TMS.
Topic Abstract 4: Perminder Sachev
DBS involves the implantation of electrodes in the brain for the continuous delivery of weak electric current into targeted brain regions to alleviate the symptoms of severe neurological and psychiatric disorders. DBS is a well-established procedure for the treatment of advanced movement disorders, such as Parkinson’s disease, tremor and dystonia. It has also been used in the control of the movement disorder associated with severe and medically intractable Tourette syndrome. In relation to psychiatric disorders, initial research has evaluated its use in the treatment of patients with severe and intractable obsessive compulsive disorder (OCD). It has been approved by the Food and Drug Administration for OCD treatment in the USA, but is still considered an experimental treatment for this disorder in most countries. Clinical trials into the use of DBS to depression are occurring international, but the benefits are not established thus far. Its use in other psychiatric disorders such as substance use disorders and anorexia is experimental. Its use in Psychiatry is controlled by legislation in many jurisdictions, and it is prohibited in New South Wales under the Mental Health Act. This talk will provide an overview of the current state of evidence for DBS in neuropsychiatric disorders and its likely place in modern psychiatric treatment.
Learning Objectives
Learning Objective 1: An Update on the use of technology in mental health care, based on physiological function.
References
Roger Gurr. Conference presentation “QEEG & Neurofeedback - Practical Benefits for ADHD, Depression, Trauma & Psychosis..” TheMHS Conference 2016, Auckland, New Zealand
Cannon E1, Silburn P, Coyne T, O'Maley K, Crawford JD, Sachdev PS. Deep brain stimulation of anteromedial globus pallidus interna for severe Tourette's syndrome. Am J Psychiatry. 2012 Aug;169(8):860-6.
Gálvez V, McGuirk L, Loo CK. The use of ketamine in ECT anaesthesia: A systematic review and critical commentary on efficacy, cognitive, safety and seizure outcomes. World J Biol Psychiatry. 2016 Nov 28:1-21.
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