Healthbeat Report: The Brain Buzz

October 14, 2011 4:48:59 AM PDT
Each year, 1.7 million Americans sustain a traumatic brain injury. That includes one in five war injuries. While medicine can keep many of those suffering the most severe cases alive after a coma, many patients have not regained function. But waking up the brain may be possible with cutting edge magnetic therapy.

Life for Josh Villa changed in an instant. After a car accident six years ago, the once active father of three was left in a coma-like state. His mother provides him with constant care.

"Everybody says, 'how can you do it?' You just do what you need to do when it's put before you," said Laurie McAndrews, mother.

A year after the accident, Villa was enrolled into a first-of-its-kind study using a magnetic therapy known as transcranial magnetic stimulation or TMS.

Dr. Theresa Pape, a clinical neuroscientist and researcher with Hines VA Hospital near Maywood, is running the study. A coil creates a magnetic field, stimulating the brain.

"If we can get these neurons up here to activate and eventually descend down to the brain stem and then ascend back up to the cortex, we should be able to facilitate the repair of the brain," Dr. Pape.

The work is especially important for injured troops. More than 300,000 have returned from Iraq and Afghanistan with a brain injury. Two thousand five hundred have severe injuries like Villa's, while about two-thirds of those will regain full consciousness. There are no treatments to get them beyond that.

"If we save their life, we have to give them a life. That's my opinion, and that's what motivates me to do what I do," said Dr. Pape.

TMS is being investigated as a treatment for many disorders, including migraine, stroke, even Parkinson's disease. But it was approved by the Food and Drug Administration in 2008 as a therapy for hard to treat depression. The non-invasive device is aimed at the brain's prefrontal cortex with the goal of resetting neurons that control mood to function normally.

Dr. William Gilmer, a psychiatrist with Northwestern Medicine, recently demonstrated the device on an employee. He says in the right patient it works.

"If you compare it with other treatments we currently use that modulate brain activity...TMS comes out looking favorable," said Dr. Gilmer.

Since the FDA approval, use of the therapy for depression has dramatically increased. But the reviews of its success are mixed, with some patients getting better results than others.

Dr. Gilmer says many of his patients have a response that lasts about six months.

"It's not surprising at all that TMS is being explored for so many different applications," said Dr. Gilmer.

As for the study with Villa, the results are promising. After 15 sessions, he went from not responding at all to holding his head up and occasionally following commands, even speaking a few words.

"Our mouths kind of hung open, and we thought, 'whoa,' and we said, 'let's see if we can repeat this," said McAndrews.

Further magnetic stimulation therapy didn't help Villa but Dr. Pape's second patient, whose name has not been released, showed even better results.

About four more people will be studied over the next three years. The next patient is set to be a veteran.

Once the safety trial is over, Dr. Pape and her team will run a randomized clinical trial using both newly-injured patients and those living with older severe traumatic brain injuries.

Chicago TMS Specialists
25 E. Washington
Suite 1601
Chicago, Il.

Cheryl Odle
Project Manager for Dr. Theresa Pape
US Dept. of Veterans Affairs

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