It looks to be a form of TMS which has already shown a lot of promise for several mental disorders. I wasn't able to look at what they changed specifically, but TMS itself is rather safe.
Instead of one long treatment in a day repeated for up to six weeks, they made it higher intensity, ten times a day, ten minute treatments on a day, repeated with patients seeing difference in three to five days and they used an MRI to target an exact location in the brain for each patient.
Not to get to into it - but last summer I had a bad episode and was recommended to ECT therapy and/or TMS (I have some other mental disorders that would also benefit from TMS). My biggest problem with both of them was that for TMS I'd have to travel a distance everyday for a month, with ECT it would only be a few times a week but somebody else would have to drive me, and it's not recommended to work during that time.
So this would be a game changer for me - I can take a week off no problem.
On safety: I'm no medical expert, my understanding is that why TMS works is not really well understood (similar to SSRI's and other antidepressants) - we just know it _tends to work_ and we have some theories for why. So from my naive perspective higher, more concentrated doses certainly sounds like it has the potential to be more dangerous - but that's just speculation.
Modern ECT causes temporary confusion and short term memory issues, but my understanding is that they generally clear up after treatment. However, it's a month long treatment, and it's not advised to work or drive during that time. I don't think long term memory loss say several months after treatment is a common problem, but I could be wrong.
To my knowledge TMS doesn't have those memory issues.
Please keep in mind that modern ECT is nothing like what people see in the movies. While I'm not at all saying it should be a first tier treatment, it's a treatment option for those with otherwise treatment resistant depression (and also a few other disorders)
I was personally referred for ECT therapy last summer by my psychiatrist. I was in the middle of a massive depressive episode, had already tried a ton of different medications (and took a break from meds to see if that would help - it didn't), diets, etc. I even mentioned to my doctor I was to the point where I was potentially thinking about self-dosing on psychedelics or ketamine because I felt I had no other options. At that point ECT therapy even with bad side effects (which again to my knowledge don't normally last forever) would be better then suicide.
I didn't go through with it because I'd have to take a month off work, and get transportation to the clinic several times a week. Personally if it gets that bad again I'm going to try to get TMS therapy, as I'm also on the ASD spectrum, and there's been some evidence that suggests it may help those symptoms as well.
A 90% response rate is in-line with ECT on non-medication resistant patients, actually, and it's not historically out of place that TMS performs so effectively. [1] [2]
Historically, TMS has had lower response rates than ECT, though this trial seems to offer a less invasive treatment with a comparable response rate. The measured response rates of the initial trials tend to drop after testing in a larger population, but it's great to see TMS progressing with improvements identified regularly.
I thought I read that some vets who received TMS treatment for PTSD still had some pretty severe mood disturbances/personality changes. I don't know if it was clearly established whether those symptoms were entirely consistent with PTSD, or whether the particular doctor responsible for many of the cases was 'doing it wrong' and needs to have his license revoked.
I suppose like most medical treatments, if the cure has a small enough probability of being worse than the disease, we will use it anyway and work on ways to deal with the side effects when they arise.
placebo is 30%-50%. Even if they invented a super placebo that worked for a while, thats pretty cool. As long as it doesnt cost millions of dollars to use.
I hope everything goes well with this treatment, and there will be no serious side effects. It can save many people's lives.