What Does TMS Stand For?

What Does TMS Stand for and How Does it Work?

TMS stands for transcranial magnetic stimulation. It’s a deep brain stimulation procedure and is used to alleviate a range of distressing mental health disorder symptoms. For people who don’t find any relief from regular medications, TMS may be a viable treatment option. Since 2008, TMS has been used for different disorders and brought relief to millions of patients. Due to its proven effectiveness and lengthening track record, more and more insurance companies are offering TMS coverage as a suitable alternative treatment option for depression.

Is TMS an invasive or painful procedure?

“Deep brain stimulation” may sound intimidating, but TMS doesn’t require an invasive, surgical procedure, does not involve pain, or anesthesia. Unlike other deep brain stimulation techniques like ECT or vagus nerve stimulation, TMS is relatively pain-free. Another massive benefit to TMS is that side effects are minimal and short-lived. Patients are awake during the procedure and get to sit in a comfortable chair without IVs or the restraint of say, an MRI machine. Recent advances in TMS also make for an even more comfortable procedure than in years past. Before, the process could be very loud. Newer models of TMS machines are quieter. 

How does TMS work?

TMS is sometimes called rTMS or repetitive TMS. During the treatment, a powerful electromagnetic coil is placed over the patient’s scalp, usually near the forehead. The coil delivers a painless pulse of magnetic energy through the skull and into the patient’s brain. The magnetic energy is used to stimulate nerve cells in the brain that are thought to regulate moods. In depressed patients, these regions of the brain are thought to be underactive. TMS reactivates them. For patients with OCD, the reverse is true. Areas of the brain thought to be overreactive are stimulated and calmed with electromagnetic energy.

Why does TMS work?

Scientists don’t fully understand why TMS works yet. Research into the mechanisms behind the procedure is still ongoing, but the results are undeniable. Approximately 25% of TMS patients will experience a full remission of depression symptoms after a TMS procedure. The power of the electromagnetic coil will create changes in the brain’s neuronal activity in regions of the brain known to impact depression symptoms. Mostly, the prefrontal cortex of the brain is targeted during a TMS session. When each magnetic pulse goes through the skull and enters the brain, the activity of the cells is impacted. 

Every patient who undergoes TMS treatment is different. So, the strength and frequency of the magnetic pulses will differ for every patient. The frequency of the pulse determines if brain activity is either increased or decreased, which helps doctors treat both depressed patients and patients with OCD. Recent studies on TMS have also found that stimulating either the right or left side of the brain can have different effects on a patient’s mood.

What happens during a TMS procedure?

TMS uses a magnetic pulse to alleviate a patient’s distress. Before starting a session, patients have to remove all metal or magnetically sensitive objects from their person. This includes things like jewelry or credit cards. While TMS is a painless procedure, the series of magnetic pulses delivered can be loud to some, so there are patients who choose to wear earplugs during the treatment to protect their hearing.

During a session of TMS, the coil has to be correctly placed on the patient’s scalp. A TMS technician will measure the patient’s head for the proper placing of the coil. After that, the coil is put over the patient’s head, not touching their scalp. Next, a technician will deliver several brief pulses to measure the patient’s motor threshold and ensure they get the right amount of electromagnetic energy.

A motor threshold is the lowest amount of power needed to cause the patient’s thumb to twitch, a type of reflexive response. This threshold is different for every patient, but measuring it is critical to ensuring that the patient gets the right amount of energy needed to stimulate the brain and induce remission of symptoms. After the motor threshold is determined, the coil is lowered and placed on the patient’s scalp, and treatment begins. 

During treatment, clicking noises are heard, and the patient may feel a slight tapping on their head where the coil is placed. Checking the patient’s motor threshold doesn’t have to happen before every procedure, but if there has been a change in the patient’s status or their medication, then the motor threshold may need reassessing.

Who can perform TMS treatment?

A qualified TMS physician will prescribe TMS treatment to viable candidates. Also, a physician will determine the motor threshold. For the procedure itself, an experienced TMS technician can administer TMS under the supervision of a physician.

During treatment, patients are never left unsupervised. A TMS technician or a physician will always be present, monitoring the procedure. If a patient becomes uncomfortable, it’s safe to stop the treatment mid-procedure without any ill side effects before starting again.

Who can benefit the most from TMS?

The FDA has officially approved TMS for both depression and OCD. Research into the treatment’s effectiveness for anxiety disorders is also ongoing. Patients who are resistant to traditional treatment methods for these disorders are the most likely to benefit from TMS treatment. There is still a lot to be uncovered about how this treatment can impact different types of mental health conditions and who else can benefit from treatment. Also, research into whether or not TMS treatment alone or TMS combined with medication is most effective for patients with severe depression.

Does TMS actually work?

Some people may think that TMS is all hype, but research actually supports its effectiveness. A 2012 study in The Journal of Clinical Psychiatry evaluated the effects of TMS on a group of patients who did not improve with antidepressant medications. TMS was found to reduce depression levels when used as an add-on to antidepressant medications, and it was well-tolerated by patients in the study. Scientists have also found TMS to be effective for treating obsessive-compulsive disorder (OCD), and they have identified specific areas of the brain that respond positively to TMS. 


The Safety of TMS

Another consideration in TMS treatment is whether it is safe. The name may sound intimidating, but this simple, pain-free procedure is also incredibly safe. In fact, a review of the research shows that TMS is safe, even when patients receive as many as five to eight sessions of treatment per day. Even older adults have been found to tolerate TMS without serious side effects. TMS is so well-tolerated that it is also safe for use during pregnancy. A follow-up study of children whose mothers received TMS while pregnant showed no significant concerns as a result of in-utero exposure to treatment, suggesting that the benefits of TMS during pregnancy outweigh the risks to the unborn child.

Other Uses of TMS

While the Food and Drug Administration (FDA) currently approves TMS for treating depression, migraine headaches, and obsessive-compulsive disorder, scientists have taken an interest in the other potential benefits of TMS treatment. For instance, some research shows that TMS may be beneficial for the following conditions:

  • Post-traumatic stress disorder (PTSD)
  •  Chronic pain
  • Drug addiction 
  • Traumatic brain injury (TBI)

While findings from studies are mixed, and additional information is needed, there is evidence that TMS may be helpful for conditions beyond current FDA-approved uses. The use of this form of treatment may grow in the future, with more and more people benefiting from this approach. 

Paying for TMS

Many insurance companies offer coverage of mental health services, which can include TMS. While coverage will vary between insurance providers, insurance is likely to cover some of the treatment costs in many, but not all, cases. You can contact your insurance provider to determine whether TMS is covered and how much you can expect to pay out-of-pocket for your treatment.

Where can someone get TMS treatment?

TMS procedures are typically carried out in a clinic or at a doctor’s office. It’s considered an outpatient procedure, and patients can drive, go to school, or work right after treatment. Are you wondering if you’re a candidate for TMS? Contact the experienced technicians at Pulse TMS today to see if you qualify. We are located in Los Angeles, and we accept multiple insurances to help cover the cost of treatment. 

At Pulse TMS, treatment begins with a confidential consultation with our psychiatrist, who will determine the best treatment plan for your situation. If TMS is suitable for you, you can expect to receive daily treatments for six to eight weeks, with flexible scheduling to accommodate your needs. Our staff may also recommend additional therapies alongside TMS to ensure you get the best results. At the conclusion of treatment, we will recommend ongoing practices, such as proper sleep and meditation, so you can maintain the results you achieved from TMS. 

Updated content on 4/30/2021