A clinical trial led by researchers at UT Southwestern Medical Center in Dallas could help bring an experimental treatment for depression closer to approval from the U.S. Food and Drug Administration.

The trial has shown that the treatment, which triggers seizures with magnets, significantly improved mental health in patients without some cognitive effects associated with electroconvulsive therapy.

The research findings on the treatment known as magnetic seizure therapy (MST) were published in Biological Psychiatry: Cognitive Neuroscience, and Neuroimaging.

“These results substantiate that MST is a safe and beneficial antidepressant neurotherapeutic treatment,” lead author Shawn McClintock, professor of Psychiatry and Investigator in the Peter O’Donnell Jr. Brain Institute at UT Southwestern, said in a statement.

UTSW said that for more than 80 years, some patients with treatment-resistant depression have found relief through ECT, which delivers electric pulses to key areas of the brain, triggering a seizure.

The mechanism for this remains unknown, but UTSW said that previous trials have shown that about half of patients who receive ECT achieve remission from their depression, which can be maintained with periodic ECT sessions, medication, and psychotherapy.

UT Southwestern said that ECT comes with a serious but temporary side effect, however.

Typically, it causes a dip in several cognitive abilities, including attention, executive function, and learning and memory. That cognitive side effect can last up to several months and can impact a patient’s ability to perform activities such as driving, working, and managing the home and finances.

“We want to do our best to minimize this because it’s one of the biggest deterrents for ECT,” Dr. McClintock said. “Some people say that these side effects outweigh the benefits.”

Comparing cognitive impacts of ECT vs. MST

Several years ago, McClintock and other UTSW researchers began investigating MST as an alternative to ECT.

UTSW said that previous studies showed that while both have success in treating depression, MST does not appear to have the same adverse effects on cognitive function. Those studies, however, were small and focused on only some measures of cognition, such as learning and memory.

UTSW said that to gather more data about both types of therapy, McClintock and colleagues from UTSW, Columbia University/New York State Psychiatric Institute, and Duke University School of Medicine worked with 73 patients who had treatment-resistant depression.

It said that three times a week, 38 patients received ECT and 35 received MST, therapies they continued until they achieved remission or their improvement plateaued.

UTSW said that before the first treatment and 24 to 72 hours after the last treatment, the researchers administered an assessment of depressive symptoms as well as a comprehensive neuropsychological battery that measured performance on a variety of cognitive domains.

Roughly half of the patients responded to each therapy, achieving significant improvement or remission from depression with an average of about seven sessions for ECT and nine for MST.

Those who received ECT experienced significant reductions in nearly all the cognitive domains, but measures for those who received MST remained unchanged in nearly every domain, even improving slightly on fine motor dexterity, UTSW said. Although both groups showed a decline in a domain called autobiographical memory consistency, the MST group declined significantly less than the ECT group, researchers said.

Effective and cognitively safe

McClintock said the findings support previous studies showing MST can deliver similar improvements in depression symptoms without temporarily sacrificing patients’ cognitive abilities.

He said that MST is both efficacious and cognitively safe.

McClintock and his colleagues plan to continue comparing the two therapies in a larger clinical trial, which will also investigate how both treatments produce positive antidepressant effects, UTSW said. McClintock holds the Lydia Bryant Test Distinguished Professorship in Psychiatric Research.

Other UTSW researchers who contributed to this study are Mustafa Husain, M.D., professor of Psychiatry and Neurology, and Vishal Thakkar, Ph.D., assistant professor of Psychiatry.

This study was funded by grants from the Stanley Medical Research Foundation, McClintock’s Young Investigator Award from the Brain & Behavior Research Foundation, the National Institute of Mental Health, and the National Center for Advancing Translational Sciences.

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