What is TMS?
Transcranial magnetic stimulation (TMS) is a cutting-edge FDA approved noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain to drastically improve symptoms of depression and other conditions.
☤ Pain Free Treatment
☆ 70-80% Effective
⚘ Little to No Side Effects
TMS therapy has been demonstrated to be safe, well tolerated, and effective in numerous clinical trials and double blind studies, with little to no side effects. Tens of millions of people around the world have received TMS therapy. Research shows it to be at least as effective as antidepressant medication. Close to 70% of patients receiving TMS therapy will feel some benefit and relief in depression symptoms - half of those patients will be in full remission after treatment.
Frequently Asked Questions
What are the most common side effects?
The most commonly reported side effects during clinical trials were headache and scalp discomfort. These potential side effects were typically mild to moderate and were less common after the first week of treatment. During clinical trials, less than 5% of patients treated with TMS discontinued treatment due to side effects. If necessary, headaches from TMS can be treated with over-the-counter pain medications. If the side effects persist, the strength of the TMS pulses can be temporarily reduced to ensure the comfort of the patient.
How does TMS work?
The mechanism of action of TMS is still not fully understood however the response to therapy is indisputable and has consistently demonstrated results in the majority of research being done in the field. The TMS electromagnetic pulse is generated by electrical current running through the TMS coil which by method of induction (Faraday’s law) generates a magnetic field perpendicular to the coil. This magnetic field passes through the skull unimpeded and in turn generates a corresponding electric field in the brain also by method of induction. This electric field is conducted by neural pathways under the coil in a somewhat unpredicable way as brain tissue is not uniform and anatomy varies from indivual to individual.
Neurons are conductive just like the rest of the nerve fibers in your body. Depending on the protocol used and frequency of TMS pulse entire regions of neurons under the coil can either become excited or inhibited. In Depression, neurons in the left DLPFC (Dorsolateral prefrontal cortex) are targeted by the coil with an excitatory protocol (FDA cleared). Subtle changes in brain state as a result of TMS can last up to several hours and even days after a TMS session has been performed. If done repetitively over a 3-6 week period TMS induces structural changes in the brain where the coil has been placed. Increased gray matter density and blood flow to the part of the brain stimulated have all been clearly demonstrated in research using MRI brain scans.
Is TMS Painful?
Painful? No. Uncomfortable? It depends on the individual. In the great majority of patients, TMS is well tolerated with only minor discomfort on the scalp where TMS is applied. Most people describe TMS as a light to a moderate tapping sensation where the coil is being applied. The sensation of the pulse may feel similar to a TENS unit. The reason for this is that there are several nerves in the scalp where TMS is being applied. Naturally, some of these nerves will also be lightly stimulated by the TMS coil as they are also conductive and will pick up the pulse. This is the part of the TMS that you can feel. You cannot feel TMS in your brain, as the brain has no pain receptors itself.
And even though stimulation of the scalp nerves may cause some discomfort at first, this too subsides as the patient progresses through treatment.
What is TMS's success rate?
Not everyone responds to TMS therapy for Depression but most people will. Many clinicians see a 70% – 80% response rate in their patient population. At least half of these responders will achieve full remission. In the literature TMS response rates when treating Depression have been shown to be at least as effective as medications used to treat Depression. And of course without all the side effects that medications bring.
How long will the benefits of TMS last?
Many patients say they can still feel the benefit from TMS therapy years after their first round of TMS treatment. The effect appears to be quite durable especially in people who respond well to treatment. In most cases, effects can be felt for up to a year. If needed, maintenance TMS therapy sessions can be done.
How is TMS performed?
TMS therapy is applied by a TMS device with a stimulating coil. The patient sits in a comfortable chair while the technician takes some measurements of the patient’s head. Once appropriate measurements have been made to determine the optimal location of the coil placement, the technician then places the stimulating coil on the patient's head and starts treatment.
What do TMS effects feel like?
Most patients report increased energy, focus, and motivation to perform activities and hobbies in as little as 5-10 sessions. Many patients describe TMS therapy as life-changing. Oftentimes family members will notice effects before the patient does. As functional MRI imaging has clearly demonstrated, TMS increases blood flow to the area of the brain being stimulated, and if done repetitively also increases gray matter density.
What do I do during treatment?
During the actual treatment itself, the patient sits and relaxes while the magnetic waves are being delivered.
Will I be able to drive home after the TMS treatment?
Yes, patients are able to resume normal activities after the treatment.