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A first in the world research pilot is using non-invasive brain stimulation called Transcranial Magnetic Stimulation (TMS) to treat teenagers with major depressive disorder. Early trial results are very promising with what appear to be high success rates and immediate gains for participants. The 3T MRI is helping researchers understand how this treatment affects the brainSince the two primary treatments currently available - anti-depressant medication and cognitive behavioural therapy - are effective in less than half of kids who receive them, new treatment options like this one are urgently needed.

Ryley landing page

It’s hard to imagine a nine-year-old wanting to end his life. Yet that was the reality for Ryley when his family first turned to the Alberta Children’s Hospital for help. Even though Micah and Donavan Leganchuk knew mental health issues affect one in five Canadians, they were shocked to learn that depression could develop in a child so young – especially their fun-loving, energetic little boy.

His first stay in hospital, then his second, provided Ryley with a set of skills to cope with his illness, but his struggles continued. Like 50% of children with mental health conditions, current therapies had limited effect. Still, Micah and Donavan refused to give up on their son - even though Ryley himself had.

Ryley-TMS-therapy_new.jpgThen, four years ago, Ryley had the chance to participate in research at the Alberta Children’s Hospital examining the effects of non-invasive brain stimulation on teens unresponsive to conventional treatments. The therapy uses Transcranial Magnetic Stimulation – or TMS – to alter the level of activity in a section of the brain called the dorsal lateral prefrontal cortex, which regulates emotion, attention span and the ability to organize, plan and function as a responsible, productive adult. The TMS lab and the 3T MRI needed to conduct the study were community funded.

“Essentially, TMS helps re-wire the boss of the brain,” says Dr. Frank MacMaster who, along with Dr. Adam Kirton, co-leads the study.

Every weekday for three weeks, Ryley went to the TMS lab – the only one of its kind in the country - to watch his favourite episodes of The Simpsons while the team sent magnetic waves into his brain. At first, Ryley and his family saw little difference. However, gradually, over the next few months, his symptoms began easing and his life began to turn around.

“I used to have two weeks straight of all bad days, then one or two good days, then another two weeks straight of bad days,” says Ryley. “Now, I might have one bad day a month, sometimes none.”

His parents say it’s a complete shift – one they’re still getting used to. Last fall, when she saw the school’s number pop up on her phone, Micah dreaded answering. After so many troubling calls from the principal’s office in the past, she braced for the worst. Instead, the teacher was phoning to say that Ryley was such a positive student, it was a joy having him in her class. A few months later, he was nominated for  a school leadership award. It was the best year he’s had at school – ever.

“We used to have to protect him from himself. Now, he’s helping coach football for 12-year-olds,” says Donavan proudly. “He is more confident, social, and willing to help others.”

Other TMS patients have experienced similar success. Early indicators show that more than three quarters of participants in the study have responded to treatment and more than half have had their symptoms reduced by over 50%. Those results attracted the attention of experts at the Mayo Clinic, who are now working with Dr. MacMaster’s group and 10 other hospitals across the United States to conduct a multi-site clinical trial with the aim to get TMS approved as a new treatment for teen depression across North America. If the larger trial is successful, TMS would be the first new therapy made available to families in more than a decade.

“This trial is the final hurdle in establishing a different therapy option for adolescent depression,” says Dr. MacMaster. “Having a new treatment on the table will be a game changer for young people and their families who face challenges that currently seem unsurmountable.”

“For the first time in a long time, our lives feel normal, not always in crisis,” says Micah. “For once, our son sees a future for himself.”

And that future looks very bright. After graduating from high school this year with honours, he hopes to study Education, with dreams of becoming an elementary school teacher.

“I’m happier,” he says matter-of-factly. Two words say so much.

“The hospital has changed Ryley’s life – and all our lives – completely,” says Donavan. “We are beyond grateful.”

Ryley with hospital


 

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