Magnetic seizure therapy reduces suicidal ideation and produces neuroplasticity in treatment-resistant depression
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Therapeutic seizures may work for treatment-resistant depression (TRD) by producing neuroplasticity. We evaluated whether magnetic seizure therapy (MST) produces changes in suicidal ideation and neuroplasticity as indexed through transcranial magnetic stimulation and electroencephalography (TMS-EEG) of the dorsolateral prefrontal cortex (DLPFC). Twenty-three patients with TRD were treated with MST. Changes in suicidal ideation was assessed through the Scale for Suicidal Ideation (SSI). Before and after the treatment course, neuroplasticity in excitatory and inhibitory circuits was assessed with TMS-EEG measures of cortical-evoked activity (CEA) and long-interval cortical inhibition (LICI) from the left DLPFC, and the left motor cortex as a control condition. As in our previous report, the relationship between TMS-EEG measures and suicidal ideation was examined with the SSI. Results show that 44.4% of patients experienced resolution of suicidal ideation. Based on DLPFC assessment, MST produced significant CEA increase over the frontal central electrodes (cluster p < 0.05), but did not change LICI on a group level. MST also reduced the SSI scores ( p < 0.005) and the amount of reduction correlated with the decrease in LICI over the right frontal central electrodes (cluster p < 0.05; rho = 0.73 for Cz). LICI change identified patients who were resolved of suicidal ideation with 90% sensitivity and 88% specificity (AUC = 0.9, p = 0.004). There was no significant finding with motor cortex assessment. Overall, MST produced significant rates of resolution of suicidal ideation. MST also produced neuroplasticity in the frontal cortex, likely through long-term potentiation (LTP)-like mechanisms. The largest reduction in suicidal ideation was demonstrated in patients showing concomitant decreases in cortical inhibition—a mechanism linked to enhanced LTP-like plasticity. These findings provide insights into the mechanisms through which patients experience resolution of suicidal ideation following seizure treatments in depression.
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Other treatments with potentially rapid effects on suicidal thoughts include transcranial magnetic stimulation, magnetic seizure therapy, and chronotherapies.
“Other treatments with potentially rapid effects on suicidal thoughts include transcranial magnetic stimulation (15), magnetic seizure therapy (16), and chronotherapies (17).”
From New methods for assessing rapid changes in suicide risk (2021) · cites this paper as [16]
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- Authors
- Sun, Y., Blumberger, D. M., Mulsant, B. H., Rajji, T. K., Fitzgerald, P. B., Barr, M. S., Downar, J., Wong, W., Farzan, F., & Daskalakis, Z. J.
- Affiliations
- Centre for Addiction and Mental Health (CA)
- Epworth Hospital (AU)
- University Health Network (CA)
- University of Toronto (CA)
- Corresponding author
- Daskalakis, Zafiris J.
- ORCID
- Venue
- Translational Psychiatry
- Published
- 2018-11-23
- Volume
- 8
- Issue
- 1
- Pages
- 253-253
- ISSN
- 2158-3188 (ISSN-L)
- PMC
- PMC6251931
- OpenAlex
- W2901304292
- Cited by
- 85
- References
- 52
- Citations by year
- 2026: 12 · 2025: 13 · 2024: 6 · 2023: 13 · 2022: 11 · 2021: 14 · 2020: 8 · 2019: 8
- FWCI
- 3.37
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Translational Psychiatry (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Monash University Research Portal (Monash University) (acceptedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Klarman Family Foundation
- Fondation Brain Canada
- Sunovion
- National Alliance for Research on Schizophrenia and Depression
- Campbell Institute
- Centre for Addiction and Mental Health
- BrainsWay
- MagVenture
- H. Lundbeck A/S
- National Institutes of Health
- Canadian Institutes of Health Research
- Natural Sciences and Engineering Research Council of Canada
- Topics
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- magnetic seizure therapy, treatment-resistant depression, suicidal ideation, neuroplasticity, dorsolateral prefrontal cortex, TMS-EEG, long-term potentiation
- MeSH terms
- Adult, Electroencephalography, Evoked Potentials, Female, Humans, Male, Middle Aged, Motor Cortex, Neural Inhibition, Neuronal Plasticity, Seizures, Outcome Assessment, Health Care, Prefrontal Cortex, Transcranial Magnetic Stimulation, Magnetic Field Therapy, Suicidal Ideation, Depressive Disorder, Treatment-Resistant
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