Transcranial Magnetic Stimulation is a new form of treatment for those suffering from depression. TMS Therapy is a non-invasive process that occurs in approximately 18-minute sessions for 6-8 weeks. No medication changes are required for treatment, and you can accomplish your daily tasks before and after each treatment session. Those who are eligible for TMS Therapy have often tried other methods to treat depression with little or no success.
Issues treated by TMS include forms of depression such as major depressive disorder, postpartum depression, chronic depression, and medication-resistant depression.
Depression affects over 300 million people worldwide and researchers think that by 2020 it will be the second leading cause of disability. In the United States, 30,000 people commit suicide each year, 60% of whom suffered from major depression.
TMS treats the left dorsal lateral prefrontal cortex which is part of the brain that goes dormant when you are depressed.
Anti-depression medication is fairly effective, but not everyone responds to it. The Journal of the American Medical Association has stated 4.5 million Americans who suffer depression do not respond to meds. TMS is often a viable choice for those who find medications ineffective.
The procedure is simple. The patient relaxes in a chair for approximately 18 minutes while wearing the Brainsway TMS machine that rests on the head. After receiving pulses from the set, the patient is then free to drive home or return to work. A typical treatment schedule is approximately 6 to 8 weeks.
Deep TMS is administered via a Brainsway machine and delivers magnetic pulses that reach deeper into the brain than the average TMS treatment. Deep TMS is one of the faster and more effective types of TMS Therapy currently available to patients.
The Food and Drug Administration (FDA) cleared TMS in 2008 for help with treatment-resistant depression. Clinical trials have been done which show TMS can treat a range of additional issues including bipolar disorder, PTSD, adult ADHD, chronic pain, and OCD.
Yes. Worldwide, TMS is either approved or being tested to help with:
Attention Deficit Hyperactivity Disorder (ADHD)
Traumatic Brain Injury (TBI)
Post-Traumatic Stress Disorder (PTSD)
Obsessive Compulsive Disorder (OCD)
Up to 23% of expectant women either enter pregnancy already suffering from a major depressive episode, or become clinically depressed during their pregnancy. Currently, there is research that shows TMS is both safe during pregnancy and successful in treating depression.
The rise in popularity of TMS is down to a handful of elements, including:
Non-Invasive – there are no electric shocks or anesthesia involved in the procedure.
Minimum Discomfort – some report a slight headache or irritation during the 18 minute procedure.
In-House – the treatment is performed at the doctor’s office, and the patient can drive home afterward.
Drug-Free – medications are not required for treatment.
The TMS therapy is administered via a covered magnetic stimulating coil that is placed over the patient’s head. The coil then generates a magnetic field that, in turn, affects the neurons responsible for mood. It has a longer-lasting effect than drugs, however, it is not uncommon for patients to get booster sessions from time to time.
Patients are asked to remove all magnetically sensitive objects from the neck up (jewelry, etc,) and are offered earplugs for comfort and hearing protection.
During the initial consultation, a mapping is done to locate the specific treatment area for each patient. During daily treatments, the coil is put in place and the patient will feel brief pulses during the 18 minute session.
After the motor threshold is achieved, treatment begins. The patient then hears a series of clicks and feels a tapping sensation from under the coil. The pulse only reaches two inches into the brain and is about as strong as an MRI scan.
The most common side effects reported in among half the patients are headaches. These are mild and often diminish before treatment is even completed. Over-the-counter pain medication is used to combat these headaches. TMS is an incredibly safe procedure.
Patient response to TMS varies. Some patient can feel a difference in the first week while it may take longer for others. It is important to complete the entire TMS cycle to feel the full benefits of treatment.
In 1976, researchers stimulated nerves with short magnetic field pulses. A decade later, a machine developed by Anthony Barker and his team was able to stimulate the cerebral cortex. They discovered that by sidestepping direct electric current and instead embracing electromagnets, pain and disruption were wholly avoided. A large, multi-site clinical investigation began in the Noughties to evaluate the NeuroStar TMS Therapy System which led, in 2008, to the FDA clearing the technology as both safe and effective.
Over 3,500 papers have been published speaking to the efficacy of TMS. One report in particular performed at Butler Hospital by Dr. Linda Carpenter and her team discovered that TMS aided people who had treatment-resistant depression. They saw a 58% positive response rate and a 37% remissions rate.
Another trial in 2010 showed that TMS led to 14% remission rate compared to 5% without it. A second phase of the trial allowed all patients – including those who had received placebo versions of TMS – to receive proper TMS and, astonishingly, remission rates rose to almost 30%.
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Research is pointing to TMS being able to address schizophrenia, anxiety, PTSD, OCD and the ability to regain movement after a stroke. Another potential benefit of TMS is in the treatment of autism spectrum disorder, but this research is in its infancy.
Additionally, work at UCLA suggests more important actions can be achieved with it using sinusoidal waveforms rather than pulses.