What is Transcranial Magnetic Stimulation?
What is TMS?
Transcranial Magnetic Stimulation (TMS) is a noninvasive, anesthesia-free treatment used to treat depression by using magnetic stimulation of the brain. During the treatment, a magnetic field is administered in short pulses to regions of the brain. The initial phase of treatment consists of coming in for treatment for 30-40 minutes for the first 4-6 weeks. After the initial phase, the patient will enter the continuation phase. The visit frequency tapers off from treatment five days a week down to once a week.
How TMS works
TMS therapy uses short pulses of magnetic fields to stimulate brain areas that function differently in patients with depression and other disorders. The magnetic field produces an electric current to stimulate brain cells, which allows beneficial changes to the brain for people who have major depressive disorder. During the TMS therapy procedure, patients sit comfortably in a chair and are awake and alert throughout the treatment.
How TMS treats major depressions
Individuals with major depression who seek help from therapists are often prescribed medication by doctors to help control the symptoms. Although this works well for many patients, there are some that medicine has little or no effect on their symptoms.
TMS is an alternative treatment that activates specific brain regions that are affected by depression. TMS targets specific areas of the brain that regulate mood with magnetic pulses. Each patient receiving TMS is mapped to find their specific location and the intensity of the magnetic pulses to stimulate their neuronal pathways in the region of the brain that should be stimulated.
Mapping provides doctors with the information they need to provide individualized treatment. Following mapping, individualized treatment sessions will begin. The treatments are not invasive, do not require any anesthesia, and consist of a series of magnetic pulses delivered to stimulate a specific brain area to enhance brain function. Several treatments are given over time to promote better neural function and relieve depression. The stimulation strengthens the neural pathways leading to symptom relief. The treatment is similar to getting the rest of your body back in shape. The treatments take time to be effective.
TMS vs. Deep TMS
Brook Lane uses a modern form of TMS called “Deep TMS” with a coil superior to older TMS machines. Studies have shown that remission rates for those who complete 30 sessions of Deep TMS were 60% vs. treatment with medications alone. The response rates for Deep TMS were 67% vs. 44% for older TMS treatments. Remission rates for Deep TMS with 30 treatments were nearly 75% vs. those completing 20 sessions with a remission rate of 65%. The treatments are specific to the brain and do not usually involve the rest of the body.
TMS therapy is well tolerated and has been proven to be safe in clinical trials. Throughout over 10,000 active treatments performed in clinical trials, the most commonly reported side effect was scalp pain or discomfort during treatment sessions. These side effects were generally mild to moderate and occurred less frequently after the first week of treatment. Less than 5% of patients treated with TMS therapy discontinued treatment due to side effects. We can usually make adjustments to reduce the discomfort. Some patients use over-the-counter remedies such as Tylenol or aspirin before treatment sessions. In clinical trials, over 10,000 TMS treatments demonstrated its safety, with no occurrence of seizures. However, there is a small risk of a seizure occurring during therapy. This risk is no greater than using oral antidepressant medications.
Who is TMS for?
While TMS therapy has been proven effective, not all patients will benefit from it. Patients should be carefully monitored for worsening symptoms, signs or symptoms of suicidal behavior, or unusual behavior. Families and caregivers should also be aware of the need to observe patients and notify their treatment provider if symptoms worsen. There is a slight risk of seizure, but these occur in less than 0.1% of people. TMS does not result in memory loss.
To see if you qualify for this exciting new treatment, please ask your mental health care provider or contact Brook Lane at TMSadmin@brooklane.org or 301-733-0331 x1146.
Lynn Feldman, DO, MPH is an adult and child/adolescent psychiatrist treating patients at Brook Lane’s Frederick outpatient office. She is certified by the American Board of Psychiatry and Neurology in general psychiatry, child and adolescent psychiatry and addiction medicine. She treats patients with a variety of disorders including autistic spectrum disorders, attention deficit hyper activity disorder, and anxiety, mood and psychotic disorders.