When Was Transcranial Magnetic Stimulation Invented and How Does it Work?
Transcranial magnetic stimulation, or TMS, is a non-invasive deep brain stimulation technique that’s used to treat a variety of stubborn mental health disorder symptoms. The treatment is non-invasive and convenient for patients who don’t respond to the traditional methods used for treating mental health disorder symptoms that happen with clinical depression and OCD. TMS is sometimes recommended for patients because many medications for mental health disorders can come with a variety of unpleasant side effects. Still, other patients may not be able to take medicines because of pre-existing health issues or other physical conditions. Learn more about the science behind TMS here.
Also, around 30% of all mental health disorder patients won’t respond to medications even with perfect use.
TMS is most often used for treating medication-resistant mental health disorder symptoms, or for augmenting a medication and therapy regimen. The FDA has approved TMS for treating a range of disorders, and studies have found that TMS therapy is highly effective by itself as a treatment method for stubborn and debilitating symptoms. Further studies have also found that using TMS in combination with therapy and medication can give patients a high level of success and help them experience full remission of symptoms.
What makes TMS an attractive treatment option for doctors and patients alike is that it does not require any significant downtime after a procedure.
Patients also do not need sedation or anesthesia before undergoing a session of TMS. Unlike ECT, patients are safe to drive, work, or go to school after receiving TMS treatment.
This also makes TMS a less expensive option, since doctors do not need to use costly and complicated monitoring equipment for anesthetized patients.
Patients are fully awake during TMS treatment, and they can read, listen to music, watch a movie, or talk during their treatment session. Several studies have found that undergoing simultaneous TMS treatment along with cognitive behavioral therapy can induce a quicker reduction in depression symptoms than TMS or therapy alone.
During a TMS treatment session, an experienced technician will place a strong, magnetic coil over certain areas of the patient’s head. The technician will administer powerful magnetic pulses through the patient’s skull and into their brain. These magnetic pulses impact the brain’s neuronal activity, and by activating these parts of the brain, patients will see a reduction in their symptoms.
The average patient will need between twenty to thirty TMS sessions before they experience a reduction in symptoms. Usually, a patient will have one TMS session per weekday, for four to six weeks.
Each session lasts between forty minutes to an hour. Some patients are fortunate enough to see a reduction in symptoms after just one week of TMS treatments, but every patient is different when it comes to the treatment’s effectiveness and how fast it will work.
Also, there are minimal side effects with TMS. Other deep brain stimulation techniques, such as ECT, can cause memory loss. But the most common side effects with TMS are mild to moderate headaches, jaw pain, muscle tension, and facial twitching. These side effects are short-lived and tend to decrease in frequency and severity with each subsequent session of TMS. Severe, adverse reactions to TMS are rarely reported. In extremely rare cases, a patient can get a seizure from TMS.
TMS was developed in the 1980s. Since then, the FDA has approved the technique for treating a multitude of disorders and adverse mental health symptoms.
When was TMS invented and who invented it?
The concept of using magnets to impact brain activity has been around for more than 100 years. But, it wasn’t until the end of the 20th century that magnetic stimulation and its ability to treat disease was proven with evidence from extensive scientific studies.
The therapeutic concepts driving the use of modern-day TMS therapy were discovered in the late 1800s by Michael Faraday. Faraday produced a magnetic field by electrifying a coil. What he found was that the changing magnetic field could also impact conductors, for example, other metal coils and even brain neurons.
It wasn’t until almost 100 years later, in 1985, that the first TMS device that doctors know today was created by Anthony Barker and a team of physicists. Current TMS devices generate magnetic stimulation through a coil that is placed over the patient’s head. The magnetic stimulation easily permeates the skull and the brain, impacting the neurons below the coil. If the magnetic field is increased or quickly changed, the neurons are directly affected. They are either depolarized, or they are directed through magnetic energy to release vital neurotransmitters – chemicals that regulate a number of different brain and bodily functions. Neurotransmitters are brain chemicals that play an active role in emotional well-being, and a lack of these chemicals or overabundance of them is attributed to a range of mental health disorder symptoms.
When did the FDA approve TMS?
After the development of the TMS device, studies were conducted on the magnet’s ability to treat the existence of depression symptoms. More than ten years after the device was created, over 90 clinical trials had been completed, along with several meta-analyses. The results demonstrated that repetitive TMS treatment was effective for treating major depressive disorder symptoms in some patients. Further randomized and multi-site studies on the technique’s effectiveness for alleviating depression symptoms prompted the FDA to approve the device for depression treatment. The first FDA approval for repetitive TMS treatment and depression happened in 2008. At that time, more studies were being conducted on deep repetitive TMS techniques, where the device was being tested on stimulating deeper areas and tissues of the brain.
From 2009 to 2012, these studies found that deep repetitive TMS could induce remission rates of up to 32.6% in patients with treatment-resistant depression, which was a much higher success rate than discovered with repetitive TMS. The patients who participated in the new studies were patients who had tried at least two or more depression medications and were unable to see improvements in depression symptoms.
The study’s promising results prompted the FDA to quickly approve deep repetitive TMS for treating resistant and stubborn depression, a debilitating and dangerous condition. The fast approval meant the manufacturer was unprepared for the launch until almost six months after receiving FDA approval. Deep repetitive TMS is recommended for patients who haven’t had success with any number of medications, or who can’t tolerate depression medications.
Since FDA approval for deep TMS occurred in 2013, the technique has become an accepted and popular method for treating stubborn depression symptoms. TMS was also recently approved in August of 2018 for treating OCD symptoms. TMS is incredibly safe, using a lower intensity and frequency of magnetic energy than a typical MRI machine.
Other deep brain stimulation techniques have met FDA approval for treating depression and other mental health disorders. However, these techniques are much more invasive than TMS and also come with more side effects. For example, electroconvulsive therapy, or ECT, is an effective treatment for depression, but patients are sedated. They can’t return to work, school, or drive after an ECT session, and memory loss is also a common side effect with ECT. Vagus nerve stimulation can also increase the risk of seizures and sudden cardiac arrest. For patients with severe depression or OCD, TMS is incredibly effective, safe, and convenient.
Patients can receive TMS treatment in a doctor’s office. It’s not necessary to travel to a hospital for TMS, and the procedure is similar to what happens during an MRI scan. Patients are seated, awake, and will hear a series of clicking noise while undergoing treatment.
Most insurance plans cover TMS treatment, including Medicare and Tricare. However, at this time, Medicaid does not cover TMS. So far, there have been more than one million TMS treatments performed in the U.S.
TMS is safe for most patients. The only people who cannot undergo TMS therapy are patients with any metal implants in their heads or necks. People with facial tattoos that use metallic ink cannot undergo TMS therapy, either.
To prepare for an appointment, patients will need to remove any jewelry or other metal-sensitive items from their body. This includes things like credit cards with a metallic strip. The clicking noises that patients hear during TMS therapy can be loud, and it is recommended that patients wear earplugs during treatment. It is possible to wear headphones and listen to music during TMS therapy, but headphones must be metal-free. Most doctor’s offices will have ear plugs that patients can use.
For people who have not responded to medications for depression or OCD, TMS is an effective, non-invasive treatment for that comes with minimal side effects. The therapy has been used for several years and is a regulated, FDA-approved procedure that’s safe for the majority of patients with treatment-resistant depression and OCD. People who reside in the Los Angeles area and wish to try TMS can contact the technicians at Pulse TMS today to schedule an evaluation for TMS therapy.