This story goes back into the archives of the psychiatric research facilities at McLean Hospital. Ten years ago, researchers were investigating the nuances of brain structure and function when the technicians on the project started to hear about something very strange: their patients were convinced that fMRI sessions were reducing their bipolar depression symptoms.
At first, the lead researcher chalked this finding up to mood swings. But as the patients’ claims became more frequent, the scientists at McLean started to wonder anew about the effects of these brain scans. Could fMRI technology actually cure depression, the number one cause of disability and suicide world wide? They decided to create a randomized trial to confirm the patient-driven rumor. And indeed, their hypothesis was confirmed: 54 patients exhibited anti-depressive effects after just one 20-minute fMRI session.
Fast forward to today and TalMedical, a fairly new start-up company out of PureTech, is driving this research into soon-to-happen clinical trials while also working to determine the efficacy and strength of fMRI treatments for depression.
“You can be the wealthiest person in the world or the funniest person in the world, but there’s no escape from depression,” TalMedical CEO Jan Skvarka says. “It’s a debilitating disease. And there’s no acute treatment for it now except for medication or electroshock therapy, which is not as brutal as it once was but is still a fairly violent solution.”
Today, psychiatric treatment and research work largely based on a system of marginal improvements – one drug improves upon the last, which improves upon the one before it. We’re working and living in a drug-based system, as few other treatments for psychiatric illness have been found to be both safe and effective. But TalMedical hopes to change that, taking this historic discovery and eventually turning it into something that may change the existing psychiatric treatment paradigm forever. TalMedical’s technology, which is called low-field magnetic stimulation (LFMS) and is based upon the fMRI findings at McLean, would offer something truly novel in an area that affects millions of people.
“The potential is enormous,” Skvarka says. “We have the potential to define the entire clinical paradigm in a disease area that is a huge cause of disability.”
This potential is the reason that the National Institute of Mental Health recently granted $4.2 million in funding to take this technology into clinical trials. As a first step, Skvarka and his team are in the midst of managing a multi-site trial (beyond McLean Hospital) with 90 patients in several of the top psychiatric hospitals in the country. At the same time, they’re also implementing a dosing trial, asking how many minutes of LFMS exposure will yield the best results. Once these trials end, Skvarka says that they will have an idea of optimal protocols before heading into an official clinical trial.
What will this procedure look like for individual patients? Skvarka says the brilliance of the technology surrounds it’s normalized process. As a non-invasive technique that uses an external device to apply a pulsed magnetic field to the brain, the LFMS procedure feels like any other basic fMRI. The procedure will likely happen in both inpatient and outpatient settings, depending on the patient’s symptoms and the severity of the depression. And while electroshock therapy often causes at least temporary memory loss, LFMS does not appear to have these kinds of adverse effects. It does, however, appear to change the biology of the brain, which Skvarka says is indicative of long-term symptom relief.
“I often use the analogy of radiation oncology,” Skvarka says. “They followed a similar pattern, taking an existing imaging modality and repurposing it into a treatment modality. We’re doing this, too – following a pattern and potentially opening new clinical areas.”
Svarka is careful to highlight the risks of a project like this, which will need to be replicated across many sites. But the potential is enormous and Tal Medical has recruited powerful minds to work with them every step of the way, too: Patrick Kennedy, John Abele, Robert Post, Mark George, Maurizio Fava and others have signed on as advisors for the project, and Atul Pande recently accepted a position as TalMedical’s CMO.
“There’s a need here,” Skvarka says. “Imagine if we didn’t have acute pain killers. We need an acute treatment for psychiatric illness.”
Jenni Whalen is the Executive Assistant of Editorial at Upworthy. She was previously MedTech Boston's Managing Editor and has an MS in Journalism from Boston University, as well as a BA in Psychology from Bucknell University. Whalen has written for Greatist, Boston magazine, AZ Central Healthy Living and the New England Journal of Medicine, among other places. She has also worked as a conference planner, ghost writer, researcher and content developer.
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