What is TMS Therapy?
Transcranial Magnetic Stimulation (TMS) is a technique involving a magnetic field to induce an electric current in neurons. It allows clinicians to non-invasively modulate the brain activity without any pain.
TMS was first developed in 1982 by Magstim. TMS has since been widely used in research settings with clinical trials on conditions such as depression, Parkinson’s disease, migraine, OCD, Schizophrenia, and eating disorders.
The FDA approved the clinical use of TMS the treatment of Major Depression Disorder in 2008.
The Magstim Rapid2 stimulator discharges current in a stimulating coil. That coil generates a magnetic pulse with field strength similar to that of an MRI machine. The magnetic field then creates an electrical current within the brain.
Repetitive TMS pulses are administered with the Magstim coil on the patient’s head, targeting the region of the brain which regulates decision making, working memory, and emotions. In depressed patients, that region of the brain (left Dorsolateral pre-frontal cortex) is shown to be non-responsive compared to healthy patients.
This depolarizes the neurons in that lobe, stimulating monoamine neurotransmitters and increased function of the electrical circuits that drive brain activity. An increase in brain activity increases blood flow, oxygen levels and sugar metabolism; the result is improved activity of the ‘feel good’ neurotransmitters (dopamine, serotonin, norepinephrine) which drastically alleviates the symptoms of depression and which provides an opportunity to achieve full remission for nearly half of the people that complete this protocol (37.5 minutes at 10 pulses/second for four seconds, 26 second intervals, 3,000 pulses total).
The initial treatment plan usually consists of 5 treatments per week over 6 week period, for an average of 30-36 total treatments. Additional treatments may be used to maintain optimal antidepressant effects. Each treatment session lasts about 40 minutes.
TMS therapy does not cause the side-effects associated with antidepressant medications. Antidepressant systemic side-effects are numerous: Anxiety, blurred vision, diarrhea/constipation, dizziness, dry mouth, headache, insomnia/drowsiness, nausea, sexual dysfunction, weight gain, and memory loss.
While TMS is only currently FDA approved for the treatment of MDD, TMS is being utilized for off-label treatment off anxiety disorders, PTSD, autism, tinnitus, chronic pain disorders, and for the treatment of addictions.