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    What is TMS Therapy?

    A non-invasive therapeutic technique that employs magnetic fields to awaken the brain.

    This procedure stimulates nerve cells in targeted brain regions associated with mood regulation using magnetic fields. It is primarily used for people with MDD who have not responded to other treatments.

    TMS utilizes an electromagnetic coil lightly placed against the patient’s head to generate magnetic pulses, targeting localized neurons in the brain, specifically those involved in mood regulation. This non-invasive technique enhances neuronal excitability, contributing to neuroplastic changes recognized for their role in alleviating depressive symptoms.


    TMS manufacturers

    Here are some widely used TMS devices, each approved by regulatory agencies for treating various mental health conditions, primarily depression.

    Numerous studies demonstrate the effectiveness of TMS for patients with treatment-resistant depression, yielding response rates of 50-60% and sustained improvements with continued sessions, making it a transformative option in mental health care and the cure for depression.

    Ongoing clinical trials are investigating optimizations in TMS, including variations in pulse intensity and frequency, as well as its applicability in comorbid psychiatric disorders and neurodegenerative diseases, representing an exciting frontier in neurotherapy.


    Different Types of TMS Therapy

    Repetitive Transcranial Magnetic Stimulation (rTMS)

    This is the most commonly used form of TMS. It involves repetitively sending magnetic pulses to specific brain areas associated with the treated condition. These pulses are generated by a figure-8-shaped coil placed on the scalp. rTMS can help stimulate underactive neurons and modulate their activity in the targeted areas, improving mood and anxiety symptoms.

    Theta Burst Stimulation (TBS)

    TBS is a newer and faster form of brain stimulation. It delivers magnetic pulses in a specific pattern with a higher concentration and shorter treatment time. It consists of short bursts of signals delivered at a high frequency. TBS is designed to provide a similar therapeutic effect to rTMS but in a shorter duration, typically lasting a few minutes.

    The efficacy of TBS is still being studied, but it has shown promise in treating a variety of conditions, including depression, OCD, bipolar disorder, and chronic pain. There is some evidence that TBS may be more effective than traditional TMS. Research shows that it can treat depression faster due to a shorter response time. For example, a study published in Molecular Psychiatry in 2024 evaluated six TBS protocols and found that they were more efficient and potentially more effective than TMS in reducing depression symptoms. Due to such research, TBS is becoming increasingly common as a treatment option. More and more insurance companies are starting to cover TBS, which makes it more accessible for people who need it.

    Deep Transcranial Magnetic Stimulation (dTMS)

    This treatment reaches deeper brain regions with an H-coil. It allows for better stimulation than the figure-8 coil used in rTMS. The H-coil creates a magnetic field that can penetrate further into the brain, targeting areas associated with specific conditions. dTMS has shown impressive results in treating major depression, OCD, and other neuropsychiatric issues. It offers the advantage of reaching brain structures that are not easily accessible with traditional TMS techniques.

    fMRI-Guided TMS

    This newer treatment uses functional magnetic resonance imaging (fMRI) to target a specific brain area. This is done by scanning the patient’s brain while they are performing a task that activates that region. The fMRI provides a map of the stimulated area. It then guides the TMS procedure, ensuring that the magnetic field focuses on that brain region. There is strong evidence that this approach is more effective than traditional TMS in treating depression and other conditions. It is also a more precise technique, so there is less risk of side effects.

    TMS Treatment Process

    Here’s a general overview of the TMS treatment process:

    Initial Consultation and Assessment

    Evaluation: The patient meets with a psychiatrist or TMS specialist to evaluate their symptoms, medical history, and suitability for TMS. This includes confirming the diagnosis (such as treatment-resistant depression or anxiety).

    Treatment Plan: The provider designs a personalized TMS treatment plan, determining the target area in the brain and the frequency and intensity of the magnetic pulses. For depression, the left dorsolateral prefrontal cortex is often targeted.

    Mapping the Treatment Area

    Precise Mapping: During the first session, the TMS technician or psychiatrist identifies the correct spot on the patient’s head to place the magnetic coil. This is done using measurements or a motor threshold test to identify the specific region.

    Adjustments for Accuracy: This mapping ensures that the TMS pulses are directed accurately at the treatment area, which is critical for effectiveness.

    TMS Sessions

    Treatment Duration: Each TMS session lasts between 20-40 minutes, depending on the type of TMS protocol being used (standard, accelerated, or theta burst stimulation).

    Magnetic Pulses: The magnetic coil delivers repetitive pulses to stimulate brain cells. This creates small electric currents that may help improve communication between nerve cells, thought to affect mood regulation.

    Relaxing During Treatment: Patients are awake during the session and can relax or listen to music. The procedure is non-invasive and does not involve anesthesia.

    Course of Treatment

    Typical Schedule: TMS treatment typically consists of daily sessions, 5 days a week, for around 4-6 weeks. Some protocols may vary in frequency and total duration.

    Progress Monitoring: The patient’s response to TMS is monitored over time, with progress evaluated through symptom tracking and feedback. Adjustments may be made to optimize outcomes if necessary.

    Post-Treatment Follow-Up

    Symptom Assessment: After completing a TMS course, the patient and clinician evaluate symptom improvement. TMS is often effective in reducing depressive symptoms, though results vary.

    Long-Term Plan: The psychiatrist may discuss maintenance options, such as follow-up TMS sessions, medication adjustments, or therapy, to sustain improvements.

    Side Effect Management: Common, mild side effects like scalp discomfort and mild headaches are typically monitored. TMS has fewer side effects than medications, with no sedation or cognitive impairment.

    Benefits and Considerations of TMS Therapy

    Each person’s experience with TMS may vary based on individual factors, but overall, TMS is an increasingly popular treatment for its effectiveness and safety.

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    Reduces Depression Symptoms

    TMS helped in reducing symptoms of depression very effectively. Patients have seen significant improvement in their mood, energy levels, sleep quality, appetite, and concentration. And the effect has lasted for 6-12 months after the completion of therapy.

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    Non-Invasive Approach

    TMS is non-invasive and doesn’t require surgery or anesthesia. Pulses pass through the skull and stimulate nerve cells when technician positions and electromagnetic coil near the scalp. The procedure is well-tolerated with few side effects.

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    Safe to Use

    TMS does not disrupt brain structures necessary for thought, speech, movement, or memory. The most common side effect is a mild headache or scalp discomfort during or after the session. More serious risks are very uncommon if appropriate screening is conducted beforehand.

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    Rapid, Convenient Sessions

    A standard TMS is of short daily sessions delivered five days a week for 4-6 weeks. Each appointment is less than an hour, and patients can return to regular activity immediately. TMS offers an advantage of convenience and relatively short duration of treatment.

    Explore our curated selection of articles on TMS Therapy

    Finding Hope When Antidepressants Haven’t Worked: Why Seeing a Psychiatrist Certified in TMS and Spravato Can Open New Doorsarrow_outward

    Why Psychiatrists may continue try antidepressant medications when there is a better optionarrow_outward

    TMS therapy for MDD in the older populationarrow_outward

    Latest Treatment Approaches for MDDarrow_outward

    Frequently Asked Questions

    Learn more about Transcranial Magnetic Stimulation (TMS), a non-invasive therapeutic technique useful in treating major depressive disorders.

    Browse all FAQs

    What is TMS, and how does it work?

    TMS (Transcranial Magnetic Stimulation) is a non-invasive treatment that uses magnetic pulses to stimulate areas of the brain involved in mood regulation, particularly the prefrontal cortex. This stimulation helps to activate under-active neurons, improving mood and relieving symptoms of depression.

    Are there any side effects?

    Most patients experience mild side effects, such as headaches or scalp discomfort, which usually improve after a few sessions.

    Is TMS covered by insurance?

    Most major insurance plans cover TMS for patients who meet the criteria, but coverage varies. It’s best to confirm with your insurance provider.

    Will TMS interfere with my daily life?

    No. After each session, you can return to your normal activities like driving, working, or exercising.

    Will I feel the effects immediately?

    Some patients notice improvement within the first couple of weeks, but full benefits are usually seen after several weeks of consistent treatment.

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