Experimental depression treatment preserves cognitive function
Magnetic seizure therapy delivers results similar to electroconvulsive therapy without the side effects, UTSW researchers report
DALLAS – Jan. 21, 2025 – An experimental treatment for depression that triggers seizures with magnets significantly improved mental health in patients without some cognitive effects associated with electroconvulsive therapy (ECT), a clinical trial led by UT Southwestern Medical Center researchers showed.
Their findings, published in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, could help bring this treatment, known as magnetic seizure therapy (MST), closer to approval from the Food and Drug Administration (FDA).
“These results substantiate that MST is a safe and beneficial antidepressant neurotherapeutic treatment,” said lead author Shawn McClintock, Ph.D., M.S.C.S., Professor of Psychiatry and Investigator in the Peter O’Donnell Jr. Brain Institute at UT Southwestern.
For more than 80 years, some patients with treatment-resistant depression have found relief through ECT, which delivers electric pulses to key areas of the brain, triggering a seizure. Although the mechanism for this remains unknown, previous trials have shown that about half of patients who receive ECT achieve remission from their depression, which can be maintained with periodic ECT sessions, medication, and psychotherapy.
However, ECT comes with a serious but temporary side effect: It typically causes a dip in several cognitive abilities, including attention, executive function, and learning and memory. This cognitive side effect can last up to several months and can impact a patient’s ability to perform activities such as driving, working, and managing the home and finances.
“We want to do our best to minimize this because it’s one of the biggest deterrents for ECT,” Dr. McClintock said. “Some people say that these side effects outweigh the benefits.”
Several years ago, Dr. McClintock and other UTSW researchers began investigating MST as an alternative to ECT. Previous studies have shown that while both have success in treating depression, MST does not appear to have the same adverse effects on cognitive function. However, these studies were small and focused on only some measures of cognition, such as learning and memory.
To gather more data about both types of therapy, Dr. McClintock and colleagues from UTSW, Columbia University/New York State Psychiatric Institute, and Duke University School of Medicine worked with 73 patients who had treatment-resistant depression. Three times a week, 38 patients received ECT and 35 received MST, therapies they continued until they achieved remission or their improvement plateaued. Prior to the first treatment and 24 to 72 hours after the last treatment, the researchers administered an assessment of depressive symptoms as well as a comprehensive neuropsychological battery that measured performance on a variety of cognitive domains.
About 50% of the patients responded to each therapy, achieving significant improvement or remission from depression with an average of about seven sessions for ECT and nine for MST. Those who received ECT experienced significant reductions in nearly all the cognitive domains, but measures for those who received MST remained unchanged in nearly every domain, even improving slightly on fine motor dexterity. Although both groups showed a decline in a domain called autobiographical memory consistency, the MST group declined significantly less than the ECT group.
Dr. McClintock said these findings support previous studies showing MST can deliver similar improvements in depression symptoms without temporarily sacrificing patients’ cognitive abilities. As such, MST is both efficacious and cognitively safe. He and his colleagues plan to continue comparing the two therapies in a larger clinical trial, which will also investigate how both treatments produce positive antidepressant effects.
Dr. McClintock holds the Lydia Bryant Test Distinguished Professorship in Psychiatric Research.
Other UTSW researchers who contributed to this study are Mustafa Husain, M.D., Professor of Psychiatry and Neurology; and Vishal Thakkar, Ph.D., Assistant Professor of Psychiatry.
This study was funded by grants from the Stanley Medical Research Foundation (05T-656 and 05T-682), Dr. McClintock’s Young Investigator Award from the Brain & Behavior Research Foundation, the National Institute of Mental Health (K23 MH087739), and the National Center for Advancing Translational Sciences (KL2 TR001115).
About UT Southwestern Medical Center  
UT Southwestern, one of the nation’s premier academic medical centers, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty members have received six Nobel Prizes and include 25 members of the National Academy of Sciences, 24 members of the National Academy of Medicine, and 14 Howard Hughes Medical Institute Investigators. The full-time faculty of more than 3,200 is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide care in more than 80 specialties to more than 120,000 hospitalized patients, more than 360,000 emergency room cases, and oversee nearly 5 million outpatient visits a year.