Understanding the role of billions of complex brain cell interactions in neurological or psychiatric disorders is opening up new frontiers in the customised treatment of conditions ranging from anxiety and depression to brain injury and tinnitus. For a business owner who struggled with anxiety and a first-time mother recovering from brain surgery, this world-class non-invasive treatment has proved helpful.
“Recent technological advancements and progress in the neuroscientific study of brain connections have made it possible to individually map the unique ‘wiring’ of a person’s brain in relation to brain function,” explains Dr Christos Profyris, a neurosurgeon who practises at Netcare Milpark Hospital in Johannesburg and heads the Connectomix Clinics.
“This cutting-edge field of medicine is unlocking ‘the final frontier’ in allowing us to analyse individual brain maps to identify and treat the underlying anomalies associated with a wide range of conditions with a neurological basis.”
TMS treatment for anxiety
“Anxiety seems to be in my genes, as a number of my relatives have experienced similar feelings. My anxiety was not crippling, but it was unpleasant to live with. I was always fretting, I suffered recurring insomnia and a racing heartbeat,” says Francois Barnard, 47, who runs his own business in the steel trade in Johannesburg.
“Previously I had consulted psychiatrists about my anxiety, but the medicines prescribed had side-effects. When I heard about this treatment option, I wanted to see if I could benefit from it.”
He says that the experience of having the brain mapping performed was as simple as going for an MRI scan, although the advanced software and different MRI sequences used reveal a detailed map of the brain.
“Dr Profyris was able to pinpoint the areas that should be stimulated in the brain based on this information, and then I went for my first treatment session at the Connectomix Clinic in Houghton. It’s not scary or painful at all. I was seated in a normal chair, and had several five-minute sessions. It just feels like a tingling sensation for a few minutes at a time, and you can get up and walk around between sessions,” Francois says, describing the transcranial magnetic stimulation (TMS) treatment.
The navigated TMS treatment, which is entirely non-invasive, involves brain stimulation sessions that last for only a few minutes, repeated over four to five hours for four days and endeavours to reset abnormal brain connectivity.
Based on personalised brain mapping technology, individualised targets within the brain are located and then treated with a precisely placed insulated coil that rests against the person’s head. The coil generates brief magnetic fields in the specifically targeted areas as identified on the brain map, stimulating the neural circuitry to help moderate or ‘even out’ irregular brain activity relating to the patient’s specific condition. There is no need for the patient to be sedated, and side effects – most commonly light-headedness or headache – are uncommon, mild and resolve within a few hours after treatments.
“After my first day of treatment, I felt normal – but different. That night I slept better than I had in years, and the following day I felt even better. I still feel the benefits nine months later, I am not feeling so anxious as I used to and my sleeping has improved too,” Francois says.
“With the advanced navigational and robotic technology and techniques we use, we can identify the stimulation targets within the brain with great accuracy based on the unique three-dimensional brain map for the individual. Ultimately this results in a highly scientifically sound treatment approach and better TMS treatment results for our patients,” Dr Profyris explains.
|Natasha Krost is pictured with her son Asher, who was only three months old when Natasha required urgent brain surgery for a potentially life threatening condition. After the surgery, she opted for TMS therapy in the hope of shortening her recovery time so that she could get back to ‘hands on’ caring for Asher. Much sooner than expected, she was able to walk again and get back to her usual activities.
|Personalised three-dimensional brain mapping is used to assess areas of the brain that are under or over stimulated, to serve as a blueprint for transcranial magnetic stimulation (TMS) therapy. TMS has applications for a wide range of conditions including tinnitus, major depression, anxiety, obsessive-compulsive disorder and addiction, and it is showing some promise for assisting certain patients with dementia, brain injury and long COVID-19.
|Based on personalised brain mapping technology, individualised targets within the brain are located, and are then treated with a precisely placed insulated coil resting against the person’s head. This generates brief magnetic fields in the specifically targeted areas, stimulating the neural circuitry to help moderate or ‘even out’ irregular brain activity relating to the patient’s specific condition. Dr Christos Profyris, a neurosurgeon who practises at Netcare Milpark Hospital and heads the Connectomix Clinics, is pictured explaining the non-invasive TMS treatment.
“Our experienced team and network of trained medical specialists provide individualised TMS treatment based on personalised connectome (brain map) analysis for conditions including mental health conditions such as major depression, anxiety and obsessive-compulsive disorder [OCD] and addiction, and it is showing some promise for assisting certain patients with dementia, brain injury and long COVID-19. Many of our TMS patients, including those for whom traditional treatments were either unsuitable or ineffective, have displayed and reported significant improvement in their symptoms and quality of life.”
“I needed to recover as quickly as possible for my baby”
Natasha Krost, a young mother and interior designer based in Johannesburg, experienced brain mapping and TMS therapy first-hand earlier this year, significantly reducing the usual post-operative recovery time after life-saving deep brain surgery.
“In 2018 and again in February this year, I had severe headaches. An MRI scan showed that there was a cavernoma, which is a cluster of blood vessels swollen with blood, in the thalamus area of my brain that was bleeding. It is a life-threatening condition, and the next week Dr Profyris performed the operation to remove the cavernoma,” she recalls.
As is common with deep brain neurosurgical procedures, Dr Profyris explained to Natasha that she would need time to recuperate from the operation. As the right hemisphere of the brain healed, this would temporarily impair the functioning of the left side of her body for several weeks or months after the procedure.
“My baby, Asher, was only three months old at the time, and I just wanted to get home to take care of him. I was meant to have at least six weeks of therapy at Netcare Rehabilitation Hospital, but I was determined to recover as quickly as possible for my baby,” Natasha says.
Five days after her brain surgery, Natasha had a specialised MRI scan to chart her individual brain map as a basis for her TMS therapy. “I was interested to see what effect, if any, TMS might have immediately, so before I went for my first session, I tried to type out a sentence, but I couldn’t type with my left hand at all, so it was a bit of a jumble. I couldn’t believe that after just one session of TMS I could type with both hands, the difference in such a short time was nothing short of amazing,” she recalls.
Within 10 days, Natasha was ready to continue her recovery at home, and continued with physiotherapy and TMS. “At first, the whole left side of my body felt weak, so I couldn’t hold my baby or change his nappy. Much sooner than expected, however, I was able to walk again and get back to my usual activities. TMS speeded up my recovery by weeks or months,” she says.
Describing her experience of the TMS treatment, Natasha says she was fully conscious throughout. “It is not painful at all. It feels like light tapping over the area being stimulated. I had six sessions of TMS in total, and by then I had recovered and was back to my usual life.”
More patients to benefit from TMS
With increasing global recognition of the therapeutic potential of transcranial magnetic stimulation [TMS] therapy, including by the US Food and Drug Administration [FDA] and the UK’s National Institute for Health and Care Excellence [NICE], Connectomix Clinics are developing African capacity in this highly specialised field and sharing its possible applications for other disciplines to benefit more patients. Unique to Connectomix is the personalised brain mapping that they perform that uses very advanced artificial intelligence algorithms.
“Through clinician training, the Connectomix Clinics are expanding the treatment options available by introducing artificial intelligence [AI] generated brain mapping and navigated TMS therapy in the fields of psychiatry, neurology and neurosurgery. As was the case for Natasha, it can also be useful as part of the multi-disciplinary treatment for patients undergoing physical rehabilitation,” Dr Profyris says.
To keep up with the local demand for this new treatment option, two further Connectomix Clinics are being established. The new clinic at Netcare Christiaan Barnard Hospital in Cape Town is expected to open in the coming months, and the third will be established to serve patients and practitioners in Sandton, Centurion and surrounds.
“We are now offering more clinicians the opportunity to learn how the connections in the brain can help in the treatment of various conditions with a neurological basis through continuous professional development webinars. We completed our first webinar series in June. We aim to share the existing global knowledge as well as our own findings on the clinical applications of TMS treatment with the wider South African medical community, as this exciting new treatment option could benefit many more people.”
“This opens up some fascinating potential for bringing relief where other existing treatment options have not, and for growing the body of medical evidence for the various applications of brain mapping and TMS treatment.”
For more information on brain mapping and TMS treatment, please visit www.connectomix.co.za.
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