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Brain Stimulation + Imaging Pack Dual Punch to Treat, Unravel Depression Circuitry

By Brenda Patoine | July 28, 2016

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An Interview with Amit Etkin, M.D.,  Associate Professor, Psychiatry & Behavioral Science
Stanford University, Investigator, VA Sierra-Pacific Mental Illness Research Education and Clinical Center

Your laboratory has been investigating the use of repetitive transcranial magnetic stimulation (rTMS) in combination with whole-brain EEG and functional MRI (fMRI) to treat depression and to help unravel its underlying brain circuitry. First, why has depression been so difficult to treat?

There are many reasons, but I think you have to start with the fact that we don’t really know what the disorder is about. Different people report different symptoms, which may reflect biologically distinct conditions. It stands to reason that the nature of the intervention can’t possibly be the same for all those different forms of what we call depression. So partly, we need to better understand the biology of depression.

Related to that is the fact that we’ve never developed a clear idea of what we’re targeting. All of our current interventions have been discovered by serendipity. To this day we don’t really know how antidepressants work. We know a lot of things change in the brain when you take an antidepressant, but we don’t really know what is causing those changes because we don’t really know what’s wrong in the first place.

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