Deep Transcranial Magnetic Stimulation (dTMS) is a recently developed treatment for various mental disorders including, but not limited to, Major Depressive Disorder (MDD), Obsessive Compulsive Disorder (OCD), and Generalized Anxiety Disorder (GAD). dTMS operates by sending pulsed magnetic fields into the area of the brain which is hyper, or hypo active. Dr. Owen Muir, an alumnus of Amherst College and the current Medical Director at Brooklyn Minds, has been working with dTMS as well as other forms of TMS in order to alleviate symptoms of mental disorders. This piece shares the stories of some of his MDD patients, portraying their journeys with dTMS through both sound and visuals.The piece focuses on 3 main aspects of the patients’ journeys:
1. The patients’ ratings on the Clinical Global Impression- Severity scale (CGI-S scale) before and after treatment. The CGI-S scale is a 7 point scale widely used by psychiatric professionals to measure a patient’s level of mental illness, with 7 being extremely ill and 1 being not ill.
2. The number of treatments patients underwent.
3. The number of failed medications patients had prior to starting dTMS treatment.dTMS works by targeting a particular area of the brain based on the disorder identified in the patient.
For patients with MDD, dTMS targets their left prefrontal lobe, or the front left side of the brain. The magnetic pulses in dTMS treatment are administered in 50Hz bursts. Each patient’s piece begins with whole number multiples of 50 Hz up to whatever score the patient has on the CGI-S scale. For example, if a patient was a 4 on the CGI-S scale before treatment, the piece would conduct the following frequencies:
50Hz x 1 (50Hz) (1st harmonic)
50Hz x 2 (100Hz) (2nd harmonic)
50Hz x 3 (150Hz) (3rd harmonic)
50Hz x 4 (200Hz) (4th harmonic)
These frequencies are then layered on top of one another. In other words, the number of harmonics present is equal to the patient’s rating on the CGI-S scale.
Additionally, there is an underlying melody that starts at the highest harmonic (where the patient started on the CGI-S scale) and proceeds down to the lowest harmonic (where the patient was on the CGI-S scale when they finished treatment).The number of pitch changes of this underlying melody indicates how many treatments the patient underwent. As the underlying melody passes the other harmonics, those levels drop out and what is left are the frequencies lower than or equal to where the patient ended on the CGI-S scale.
Once they reach their last CGI-S score, there are a few seconds where a frequency 1Hz above the highest frequency is played. This creates long obvious beats. The number of beats before the resolve is how many failed medications that patient tried before receiving the dTMS treatment.
Through this piece, listeners can experience a bit of 30 patients’ journeys with dTMS treatment for MDD. It is a testament to mental health, vibrations, and the importance of perseverance.