Learn about six of the latest trends in health care and the leading Valley doctors who perform them
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Dr. Pardell (right) demonstrates a transcranial magnetic stimulation (TMS) session with his son Logan Pardell (center) and nurse Constance DeFreest
Photograph by Michael Polito
Using magnets to fight the blues
Severe depression cripples the lives of nearly 15 million Americans every year, according to the National Institute of Mental Health. Psychiatrist Randy Pardell, M.D. uses a new technique that he says shows great promise for many patients who suffer from major, treatment-resistant depression.
Transcranial magnetic stimulation, or TMS, uses magnetic fields to stimulate nerve cells in a region of the brain associated with mood regulation and depression. “It’s kind of like a spark plug for the brain,” explains Pardell, who heads the Poughkeepsie-based TMS Center of the Hudson Valley.
Here’s how it works: The magnetic pulses trigger gentle electrical currents in the brain, which stimulate nerve cells in the prefrontal cortex. The nerve cells release chemicals known as neurotransmitters, which affect mood and emotion.
One reason why TMS is an exciting option is because it does double duty, Pardell says: It often improves mental functioning, as well as motivation and energy, in the patient. At the same time, the procedure also appears to calm the anxiety centers of the brain, which are often overactive in people who are depressed. “Also, it’s a noninvasive, nonsystemic technique. When a patient takes a pill, it goes through the entire body. But here, the magnetic pulses are going directly to the area being treated.”
At first glance, a TMS session looks a bit like science fiction. The patient sits in what looks like a dentist’s chair; a small piece of equipment containing an electromagnetic coil is placed near the left side of the forehead. The coil emits pulses of highly concentrated magnetic fields through the skull, about three centimeters down into the brain — in a manner similar to the way an MRI unit works. “In fact, it’s the same level of magnetic intensity as an MRI — which has been used for years with very few negative consequences,” Pardell says. The patient feels a sort of tapping on the head as the magnets pulse. Afterwards, he or she can continue with normal daily activities. Side effects are mild, Pardell says: a few patients experience a mild headache or lightheadedness.
A standard TMS course involves approximately 20 sessions — five days a week for a month. “Each session takes about 37 minutes, during which about 3,000 to 4,000 pulses are given each time,” according to Pardell. The procedure has been government-approved since 2008. “The FDA approved it for use with resistant depression in adults who have tried antidepressant medication for at least a month with no improvement, or for people who have intolerance to antidepressant medication,” Pardell says.