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New neuronavigation technology in experimental treatment

By Hartford Hospital

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A new research program makes the Institute of Living only the second in the country to investigate the use of neuronavigation in combination with transcranial magnetic stimulation (TMS) to treat generalized anxiety disorder (GAD).

TMS is an FDA-approved treatment for depression which delivers magnetic pulses on the surface of the scalp. Typically, a standardized “a one-size-fits all” measurement is used to figure out where to place the magnetic coil. In neuronavigation, the location is found using each person’s unique brain scan. The brain scan is synched in real time using 3-D images with the TMS machine to allow for a more precise delivery of the treatment. Neuronavigation has been shown to improve how well the treatment works for depression.

Researchers at the Institute of Living are now conducting a clinical trial to see if using neuronavigation together with TMS can also successfully treat GAD.

People with GAD are worriers. While everyone worries to some extent, people with GAD worry excessively about many different things, and cannot easily stop. The worrying often comes along with other symptoms, like feeling restless, keyed up, and irritable. Problems with concentration, muscle tension, and sleep disturbance are also common.

“This is all very new,” said Gretchen Diefenbach, Ph.D., who is the principal investigator on the study. “There has only been one other study conducted using this treatment for GAD.”

In the previous study, conducted by researchers at the University of California Los Angeles, 10 people with GAD received the treatment, and of these 60% were considered to be responders.

“Those numbers are promising,” noted Diefenbach, “because GAD is notoriously difficult to treat, and traditional therapies like medications and counseling typically have response rates around 50%. But we need more research before we can draw conclusions about how well this treatment works for GAD.”

In the study at the Institute of Living, all participants will go through the same procedures, but half will be randomly assigned to receive the treatment, and half will be in a “control” group. Participants in the control group will receive a magnetic pulse that is so low, that it is not expected to have a therapeutic effect.

“We are also continuing to refine where we put the magnetic pulse to treat GAD,” said Diefenbach. “To do this we are conducting an additional study to learn more about brain activation during different types of tasks associated with anxiety, such as decision making tasks.”

In this study, brain scans from participants with GAD and individuals without psychiatric problems will be compared.

“With information from this study we plan to develop an even more personalized, and hopefully more effective, treatment for patients with GAD in the future,” said Diefenbach.

If you would like to learn more about this research program, or to see if you qualify for one of the ongoing studies, go to www.generalizedanxietydisorder.com, or e-mail ADCResearch@harthosp.org.

About the Institute of Living

The Institute of Living was founded in 1822. It was one of the first mental health centers in the United States. Today, the Institute of Living is a division of Hartford Hospital. It continues to be one of America’s leading not-for-profit centers for comprehensive patient care, research and education in the fields of behavioral, psychiatric, and addiction disorders. Community commitment is strong at The Institute of Living. The Institute of Living is proud to contribute to the stability and strength of its immediate neighborhood and the city beyond.

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