1. BEST BRAIN STIMULATION TREATMENT FOR MENTAL ILLNESSES By Liam Phelan

2. THE PROBLEM Major Depressive Disorder: MDD effects approximately 9.9million American adults. Major Depressive Disorder: MDD effects approximately 9.9million American adults. If not properly treated it can become treatment-resistant depression. If not properly treated it can become treatment-resistant depression. There are estimated 7-10million people world wide who suffer from Parkinson’s Disease. There are estimated 7-10million people world wide who suffer from Parkinson’s Disease. There are 60,000 Americans diagnosed each year with Parkinson’s. There are 60,000 Americans diagnosed each year with Parkinson’s. http://www.pdf.org/en/parkinson_statisticshttp://www.miraresearch.org/understanding/statistics/

3. BRAIN STIMULATION THERAPIES There are three main types of brain stimulation therapies: There are three main types of brain stimulation therapies: Electrocompulsive Therapy (ECT) Electrocompulsive Therapy (ECT) Transcranial Magnetic Stimulation (TMS) Transcranial Magnetic Stimulation (TMS) Deep Brain Stimulation (DBS) Deep Brain Stimulation (DBS) A subfield of this is transcranial Direct Current Stimulation (tDCS) A subfield of this is transcranial Direct Current Stimulation (tDCS)

4. ELECTROCOMPULSIVE THERAPY (ECT) Used to treat depression Used to treat depression Can use one diode (unilateral) or two diodes (bilateral) which are placed on scalp in target areas. Can use one diode (unilateral) or two diodes (bilateral) which are placed on scalp in target areas. Patients are put under with anesthia and given a muscle relaxer Patients are put under with anesthia and given a muscle relaxer Patients are shocked for around a minute. Patients are shocked for around a minute. Multiple sessions needed to treat Multiple sessions needed to treat http://www.nimh.nih.gov/health/topics/brain- stimulation-therapies/brain-stimulation- therapies.shtml#Fitzgerald Side Effects Headache Muscle ache Upset stomach Short term memory issues

5. TRANSCRANIAL MAGNETIC STIMULATION (TMS) Used to treat depression Used to treat depression Electromagnet placed over target area Electromagnet placed over target area Stimulus sent to electromagnet in pulses Stimulus sent to electromagnet in pulses Treatment lasts ~40 minutes Treatment lasts ~40 minutes Only a few sessions needed Only a few sessions needed Side Effects Headache Muscle contractions in face and jaw discomfort Lightheadedness http://www.nimh.nih.gov/health/topics/brain- stimulation-therapies/brain-stimulation- therapies.shtml#Fitzgerald

6. DEEP BRAIN STIMULATION (DBS) Used to treat Parkinson’s and most recently used in depression trials Used to treat Parkinson’s and most recently used in depression trials Two electrodes implanted in brain (generally at motor cortexes) Two electrodes implanted in brain (generally at motor cortexes) Pulse generator implanted in chest, sends constant pulse to electrodes Pulse generator implanted in chest, sends constant pulse to electrodes http://www.nimh.nih.gov/health/topics/brain- stimulation-therapies/brain-stimulation- therapies.shtml#Fitzgerald Side Effects Surgical liabilities Unwanted mood changes Movement disorders Lightheadedness Trouble sleeping

7. TREMTEX STIMBAND Used to treat Parkinson’s disease Used to treat Parkinson’s disease Uses transcranial Direct Current Stimulation Uses transcranial Direct Current Stimulation Electrodes placed over motor cortexes Electrodes placed over motor cortexes Used in 20 minute periods daily Used in 20 minute periods daily Stimband not tested on humans yet, tDCS however has been Stimband not tested on humans yet, tDCS however has been http://www.baltimoresun.com/health/maryland- health/bs-hs-parkinsons-device-20150716-story.html http://hub.jhu.edu/2015/06/10/stimband-brain- stimulator http://www.bme.jhu.edu/news-events/news- highlights.php?id=510 Side Effects of tDCS Headache Lightheadedness Nausea https://en.wikipedia.org/wiki/Transcranial_direct- current_stimulation#Side_effects_of_stimulation

8. ECT DATA http://www.ncbi.nlm.nih.gov/pmc/articles/PMC390524 4/

9. TMS DATA http://archpsyc.jamanetwork.com/article.aspx?articleid =207938

10. DBS DATA Patient #123456Group GenderFMFMMF3F/3M Current age 48594548373946 ± 8 Age MDD onset 18452140193429.5 ± 12 Current episode (yrs) 1.53681055.6 ± 3 # Lifetime episodes 12931214.7 ± 5 Hamilton depressio n score (17 item) 29202724262525 ± 3 Past ECTnoyes 5 of 6 Past psychothe rapy yes 6 of 6 Family history MDD yesnoyes 5 of 6 DSM IV diagnosis UPBPIIUP 5 UP Melanchol ic subtype yesnoyesnoyes 4 of 6 Current medicatio ns a a 1–51, 31–41, 2, 4, 6, 7 1, 71, 4, 5, 7 TimeHamilton Score a a Pt 1 b b Pt 2 c c Pt 3 b b Pt 4 c c Pt 5 b b Pt 6 b b Preop baseline 292229242625 1 week postop (acute stimulatio n) 51012181712 2 weeks postop (DBS off) 913231822n/a 1 month101417202212 2 months131112181012 3 months2151425714 4 months491224612 5 months5187238n/a 6 months515923612 http://www.sciencedirect.com/science/article/pii/S089 662730500156X

11. STIMBAND DATA https://youtu.be/vrpVYfQaevw?t=2m59s

12. RESULTS AND COMPARISON ECT is still very effective, probably the best option for what it can treat. ECT is still very effective, probably the best option for what it can treat. TMS has little to no effect on individuals suffering from depression. TMS has little to no effect on individuals suffering from depression. Use of DBS for Parkinson’s is costly and ineffective Use of DBS for Parkinson’s is costly and ineffective However, it use to cure MDD is very promising However, it use to cure MDD is very promising The stimband and use of tDCS is very promising towards the control of Parkinson’s symptoms, and is the best Brain Stimulation treatment for that neu The stimband and use of tDCS is very promising towards the control of Parkinson’s symptoms, and is the best Brain Stimulation treatment for that neu

13. QUESTIONS?