In This Video
- Here, Joan A. Camprodon, MD, PhD, discusses how he is using neuromodulation technology in his research to create individualized treatments for depression
- Neuomodulation technologies, like TMS and transcranial direct current stimulation, can be used to target pathways in the brain associated with particular disorders
Joan A. Camprodon, MD, PhD, is chief of Mass General's Division of Neuropsychiatry, director of the Transcranial Magnetic Stimulation (TMS) Clinical Service and director of the Laboratory for Neuropsychiatry & Neuromodulation. In this video, he discusses creating individualized treatments using TMS for patients with depression and using TMS to reduce suicide risk in other patients. He also discusses the use of transcranial direct current stimulation (tDCS) as a precognitive therapy to improve executive function in patients across the neurological and psychiatric spectrum.
Of the different projects that are going on in our lab, there may be three domains that we are most excited about. One is our capacity to develop individualized treatments with TMS. To use image-guided strategies to identify the specific targets for an individual with depression that should be modulated with devices like TMS. And then to use that to get better clinical outcomes, better response and better remission rate.
Another area of interest and promise is around suicide. We've been identifying how ECT, which is the oldest and most effective neuromodulation treatment in psychiatry and neurology, how that treatment leads to the improvement of suicide risk. The patient is suicidal and receives ECT. No matter what core diagnoses they have, they will improve their suicide rates where they have higher potential of doing that.
Through imaging studies, we've identified where the certain dynamic, the change before and after ECT, leads to improvement of suicide rates. So, we have a signature that gives us a pathway towards improvement of suicide risk, and now we're using TMS to engage the signature. So not use ECT but TMS, which is more focal. It's safer. It doesn't require anesthesia, doesn't require seizures, as a potential new anti-suicidal treatment.
And a third domain would be with a different device. That would be transcranial direct current stimulation, or tDCS, and we're using this device as a precognitive therapy to improve the executive symptoms in patients across the neurological and psychiatric spectrum.
We've identified combining that with EEG. The capacity to engage the executive function circuits and modulate them in a way that, across disorders, leads to improvement in certain aspects of executive function and cognition.
We've seen not only cognitive and clinical improvement, but what we've seen with EEG is a physiological signature that is modulated and engaged by the intervention, by tDCS, and that engagement explains the clinical improvement. So, we have a biomarker and target that explains at the circuit level how we're able to improve executive function in patients. That's executive functions that, again, are pervasive across patients with depression, with bipolar disorder, with schizophrenia, with ADHD, with TBI, with stroke, with MS, with Parkinson's disease, with frontal temporal dementias—you name it.
And our role is to try to bring this individualized information in the development and application of treatments so that we can not just treat depression, for example, but we can the treat the depressive symptoms of a given subject who's sitting in front of us.
Learn more about the Transcranial Magnetic Stimulation Clinical Service
Learn more about research in the Department of Psychiatry