COVID-19 and mental health problems
applicaiton of electromagnetic energy pulses to circuits involved in the disorder
H-coils. Each one is desgined to treat different disorders.
dTMS device with H-1 Coil for Depression
scientific proof and approval by the FDA
Research and Neuromodulation Clinical Unit
Neurocovid app prototype
according to World Health Organization in this emergency situation, due to covid-19, people suffering from mental disorders are experiencing aggravation in their symptoms (Druss, 2020) . Why? well, the confinement and the uncertainty about the upcoming months increase anxiety levels (Andersen et al., 2000). Anxiety is the base from which most emotional and physical symptoms start to develop. As anxiety increases, so do the symptoms of different disorders. How is this important? there have been already several cases of people who have decided to end their lives during this crisis. Recurrent thoughts about suicidal ideation are one of the most important symptoms that must be taken care of now!
the problem we face
given the current crisis due to covid-19, most people diagnosed with psychiatric disorders will experience aggravation in their symtomps. Anxiety increases as a result of confinement and therefore symptoms will worsen too. It is important to consider that the quality of life and symptoms of these people are worsening in situations of crisis like this one. There will be consequences once this is over and therefore it is quite relevant to treat now these patients to avoid the deterioration of their life (Druss, 2020). This is why we are working on this project with eagerness to offer a solution from which as many people as possible can benefit.
the solution we offer
to apply deep Transcranial Magnetic Stimulation, deep TMS, a non-invasive technique to treat psychiatric disorders such as Depression, Anxiety Disorders, Post Traumatic Stress Disoder, Bipolar Disorder, Schizophrenia, Substance Abuse, Dual Pathology, etc. It does not require anesthesia, and does not have secondary effects. The protocols indicated for each disorder have been approved by the Food and Drug Administration (FDA) in USA and the European Medicines Agency (EMA) in Europe.
how does deep Transcranial Magnetic Stimulation (deep TMS) work?
deep TMS is a non-invasive NEUROMODULATION technique. It applies electromagnetic energy pulses directed to specific brain areas and circuits (both superficial and deep) that are involved in the pathology to treat. There are several H-coils that are designed to stimulate deep circuits so their neurons can liberate neurotransmitters.
how are we going to do it?
- an app evaluates the inclusion criteria: the app serves as screening to see if the person interested in receiving the treatment meets the requirement to be treated.
- confirmation from the medical staff: a doctor will examine whether the person, indeed, can receive the treatment.
- booking an appointment: the app will allow the person to book an appointment to start the treatment. Moreover, the app will generate a certificate of displacement so the person can attend the clinic.
- beginning of treatment
comparing regular pharmacological treatment vs Neuromodulation (deep TMS)
|PHARMACOLOGICAL TREATMENT||DEEP TMS|
|1. the patient starts to feel bad - symptoms, for example, feeling lonely, no motivation, no energy, sad, cries often...||1. the patient reaches Neurocavis (app, phone call or via email) and books an appointment with us.|
|2. the patient reaches his/her general practitioner who might send the patient to psychiatry||2. after the interview to make sure that the person meets the inclusion criteria and calculating the Motor Threshold (min quantity of energy used to stimulate motor neurons) the treatment can start.|
|3. psychiatrist diagnoses (gives a name to the symptoms), for example, "resistant depression" and decides to prescribe antidepressants.||3. on average, the treatment lasts for four months (approx, depending on the disorder to treat, each one has a specific protocol).|
|4. the patient starts taking antidepressants for an uncertain period of time. Most of the times antidepressants do not work and the psychiatrist changes medication, increase dose, or adds pills to the list (depending exactly on how the comorbidities are).||4. during this period the person, _taking into account interpersonal differences_, will start to feel better and this is tracked by the psychological tests we administer before and after the treatment.|
|5. the energy pulses that modulate the brain keep the neurotransmitters being liberated in the circuits, therefore the improvement is usually kept during time.|
|It is very likely that the patient does not achieve complete improvement and therefore has to visit the psychiatrist several times to change medication or increase dosage. Moreover, the sustained remission rate from pharmacological treament is scarce (Papadimitropoulou, Vossen, Karabis, Donatti, & Kubitz, 2017).||It is important to take into account that by being treated with deep TMS it does not mean that the patient should stop taking the pharamacological treatment at all! on the contrary, it is necessary that the patient has been taking the pharamcological treatment at least during 2 months before starting and during deep TMS, and if the doctor considers, the patient could start decreasing the dose depending on the patient's improvement.|
what is then the benefit?: On average, the person treated with deep TMS will, eventually, stop with the pharmacological treatment (money saving). The efficacy of deep TMS is around 65 to 72% being higher than pharmacological treatment and placebo effect (Hung et al., 2019). Moreover, it has been studied that dTMS, as a monotherapy or complementary therapy, is superior to antidepressants in preventing depressive relapse/recurrence (Wang et al., 2017).
what's next for NEUROCOVID? what do we need?
we need institutional support from the EU community to
- evaluate this project by Public Health Care organisms willing to implement deep TMS treatment as soon as possible in the European Community - deep TMS should be a universal service
- acquire infrastructures in which deep TMS can be applied in across Europe: a network of trained centres that can obtain deep TMS devices. There is already a clinic in Madrid, Spain: Neurocavis.
- make society aware of neuromodulation (deep TMS) as a treatment for psychiatric disorders
- give possibility to people suffering to have access to deep TMS.
Andersen, H. S., Sestoft, D., Lillebæk, T., Gabrielsen, G., Hemmingsen, R., & Kramp, P. (2000). A longitudinal study of prisoners on remand: Psychiatric prevalence, incidence and psychopathology in solitary vs. non‐solitary confinement. Acta Psychiatrica Scandinavica, 102(1), 19-25.
Druss, B. G. (2020). Addressing the COVID-19 pandemic in populations with serious mental illness. JAMA Psychiatry, Hung, Y., Yang, L., Stubbs, B., Li, D., Tseng, P., Yeh, T., . . . Chu, C. (2019). Efficacy and tolerability of deep transcranial magnetic stimulation for treatment-resistant depression: A systematic review and meta-analysis. Progress in Neuro-Psychopharmacology and Biological Psychiatry, , 109850.
Papadimitropoulou, K., Vossen, C., Karabis, A., Donatti, C., & Kubitz, N. (2017). Comparative efficacy and tolerability of pharmacological and somatic interventions in adult patients with treatment-resistant depression: A systematic review and network meta-analysis. Current Medical Research and Opinion, 33(4), 701-711.
Wang, H., Wang, X., Zhang, R., Wang, Y., Cai, M., Zhang, Y., . . . Liu, J. (2017). Clustered repetitive transcranial magnetic stimulation for the prevention of depressive relapse/recurrence: A randomized controlled trial. Translational Psychiatry, 7(12), 1-9.