Alberta doctor aims to treat childhood depression with magnetic stimulation

Frank MacMaster sits alongside his computer screen showing a traditional MRI, right, and a Diffusion Tensor Image, left, in his Alberta Children's Hospital office in the Behavioral Research unit. 

CALGARY — Dr. Frank MacMaster wants people to rethink mental illness in children.
“The knee-jerk reactions are, ‘They must be terrible parents, or ‘The kid’s just faking, stop it.’ How do you tell a kid with obsessive compulsive disorder to just stop it? Or, worse, ‘Don’t tell anyone, keep it a secret,’” says MacMaster, a pediatric neurobiologist and researcher recruited from Detroit a year ago to work at Alberta Children’s Hospital.

He points to a 2008 poll that found 46% of Canadians think people use the term mental illness as an excuse for bad behaviour.
“That’s horrifying. If people were picking on kids with cancer or epilepsy, the outcry would be colossal. It would be a national emergency.”
MacMaster will be using a state-of-the-art MRI scanner in his research to observe brain structure, chemistry and function in children and youth. In the past, scientists could only see inside the brain during surgery or, worse, after death.
His mission is to look at the biological underpinnings of mental-health problems when they start in kids and teens, to try to understand what’s going wrong and to develop better ways of treating them.
His big research project is looking into using transcranial magnetic stimulation, or TMS, for kids and youth with depression — a first. He’s investigating if there’s a way to use TMS to stimulate or “coach” the brain’s prefrontal cortex, the area responsible for executive function, to take charge more than it typically does in depression.
About 2% of children have depression, but that figure rises to 10% in adolescents. It’s thought puberty, with its hormonal and physiological and cognitive changes, is the trigger.
TMS is being used as a treatment in adults in the U.S and has been seen to work best in young adults “where the prefrontal cortex is still more plastic and can change,” he says. “But nobody’s really done it on kids.”
For years, psychiatric medications were developed for adults and then used in children and teens, without a lot of evidence about their effects on the developing brain, he says. Given that only 30% to 45% of teens respond to drugs and it takes up 20 years to bring new ones to market, “we need new ideas for treatment, and fast.”
His other project, still in its infancy, is looking into using aerobic exercise as an intervention for depression in teens.
“There’s a lot of great data out there that exercise is a great way for reducing depression symptoms. From a neurobiology point of view, effective aerobic exercise actually helps encourage growth of the hippocampus — a part of the brain that in depression really takes a beating from the disorder,” he explains.
The side-effect of exercise, he says, is general good health.
“The message I’m trying to give people is that your brain is just another body part. If you broke your leg, you’re going to have trouble with your hockey or golf game. If you have a problem with your brain, you’re going to have problems with behaviour. It really is that simple,” says MacMaster.
“The brain’s not immune to trouble. It can have problems, just like a kidney or a liver. People need to move beyond that out-dated assumption, that it is character or weakness.”