Transcranial Magnetic Stimulation
Sometimes, traditional approaches to treating depression are not enough to give someone relief from their symptoms. In these cases, a doctor may decide to prescribe transcranial magnetic stimulation therapy, or TMS. This non-invasive treatment uses electromagnetic waves to stimulate certain areas of the brain. While this may sound frightening, it is a far cry from the “electric shock” therapies of the past, which had side effects ranging from confusion to short-term memory loss. For those with treatment-resistant depression, transcranial magnetic stimulation therapy can provide relief from their depression with very few side effects.
Research into transcranial magnetic stimulation therapy began in the 1980s, as doctors were trying to understand how improper brain function may contribute to depressive symptoms and other mood disorders. Scientists spent over two decades learning and understanding how TMS could treat depression before it became a treatment option in the United States in 2008. These days, it is considered a safe and effective treatment method for people with depression that does not respond to other treatments.
How Does Transcranial Magnetic Stimulation Therapy Work?
TMS (transcranial magnetic stimulation) therapy is a novel approach to achieving remission in depression. It works by non-invasively accessing and stimulating specific regions in the brain that are underactive in depression.
We use your unique neuroanatomy to map these regions in the brain and calculate a treatment dose which is specifically calibrated to your individual physiology. TMS uses magnetic pulse waves to help restore function and connectivity between regions of the brain- this is called neuroplasticity
Depression is a serious illness that effects approximately 350 million people worldwide. While medications may help manage symptoms, many patients are not satisfied with the results they receive from standard medication therapy.
During a TMS session, a special coil is placed on your scalp, usually above or near your forehead. Then, a small magnetic pulse is delivered into your brain, which stimulates the nerves in the area responsible for mood and emotion. The process is totally painless, and is thought to help reawaken parts of your brain that depression has slowed or shut down. There are three different types of TMS therapy.
- Traditional TMS – Sends a constant, uninterrupted signal to the brain
- Repetitive TMS – Also called rTMS, it sends rapid, repeating individual signals to the brain
- Theta Burst – A more recently FDA approved/cleared protocol. Here the pulses are delivered in a certain pattern or burst which is able to reduce the treatment time by providing more pulses within each burst. One such protocol for depression can provide the effective number of pulses in a 3 minute treatment. Theta burst is well tolerated and many patients prefer the shorter duration.
What are the Benefits of TMS?
The biggest benefit of TMS is giving people relief from their depression symptoms when other treatment plans have failed to work. While therapy is often very beneficial for people who are dealing with depression, it only addresses the mental and emotional aspects of depression, not the physical ones. TMS helps to boost recovery from depression by addressing the physical effects that trigger symptoms. It also presents a safer, less risky alternative to other forms of brain stimulation, and is able to be performed in an outpatient setting. In addition, TMS also helps to reduce the risk of death due to depression. It can be utilized as a long-term solution to depression, increasing your chances of being able to live a long, happy, and healthy life.
Transcranial magnetic stimulation therapy has many advantages over other types of brain stimulation techniques. It does not require surgery or implant devices, sedation or anesthesia, and it also carries only a very small risk of seizures. Most people experience very mild side effects that go away shortly after your session is completed, and become less common as you continue treatment. The most common side effects include:
- Scalp discomfort around the area of stimulation
- Tingling, spasms, or twitching of the facial muscles
If you do have these side effects, your doctor can decrease the level of stimulation to help avoid them. They may also recommend you take a low-dose pain reliever before treatment. There is a very small risk of additional, more serious side effects for some people. These can include seizure, hearing loss if hearing protection is not worn correctly, and for people with bipolar disorder, manic episodes.
TMS Therapy is Safe and Effective
- Transcranial Magnetic Stimulation (TMS) received FDA approval in 2008 for Major Depressive Disorder.
- TMS is non-invasive and targets highly localized parts of the brain so it avoids systemic side effects (compared to medications which go all over the body)
- TMS therapy is safe & effective and can be conducted in the physician’s office
- Each treatment is under 20 minutes and the patient is awake and alert during treatment.
- Patients typically receive treatments once per day, five days per week for six weeks
- Wave Treatment Centers offers advanced treatment protocols like Express TMS™ which can reduce treatment time to 3 minutes per session when indicated (Theta Burst)
The first treatment takes closer to an hour because we are mapping your unique brain characteristics and calculating the dose based on your motor threshold (MT). Subsequent treatments are usually scheduled for about 30 minutes which includes getting you comfortable in the chair and placing the treatment coil in the correct location. Actual coil activation protocols can be anywhere from a few minutes up to 30 minutes with 19 minutes being the most common. Most people will be prescribed sessions five days a week for four to six weeks. They typically take place at a doctor’s office or clinic that specializes in this type of treatment. Your first session will usually be a little longer than subsequent sessions, as your doctor must first determine the most effective magnet placement and intensity for you. You will be sitting in a comfortable chair at a slight recline so that you can relax, and you will remain awake for the entire procedure. You will also be provided with ear plugs to protect your hearing from the noise of the machine. After treatment, you will be able to do your normal daily tasks, including driving, and going to work or school.
While TMS may not work for everyone, those that do see results will find their depressive symptoms decreasing or going away entirely within a few weeks of starting treatment. Sometimes “maintenance TMS” will be prescribed where you will receive treatment once per month on average to help avoid the return of symptoms. If your symptoms return, you can most likely begin a new round of TMS therapy.
- FDA Cleared/Approved treatment
- Series of pulsed magnetic stimuli to the brain
- Safe, with high tolerability
- Most common side effects from TMS are transient headache & nausea
- No negative effects on cognitive function
- Patients are awake during and able to resume daily activities right after treatment
- May be used with or without antidepressants (determined by physician)
- Covered by most insurance providers
Transcranial Magnetic Stimulation in Philadelphia
If you are suffering from treatment resistant depression, this does not mean that you have no hope of relief. Transcranial magnetic stimulation therapy is a safe and effective treatment option that may help you to overcome your depression symptoms. Contact us today to learn more about TMS, and if you may be a good candidate for TMS therapy.