TRANSCRANIAL MAGNETIC STIMULATION
(TMS)
“TMS represents an important breakthrough in the treatment of depression"
K. Lanocha, MD. Transcranial magnetic stimulation: clinical applications for psychiatric practice. American psychiatric publications.
​
What conditions does TMS treat?
​
​
​
​
​
What are the advantages of TMS over other therapies?
​
​
​
Click on links to learn more
What is TMS?
1) Janicak, P. G., & Dokucu, M. E. (2015). Transcranial magnetic stimulation for the treatment of major depression. Neuropsychiatric disease and treatment, 1549-1560.
Trancranial Magnetic Stimulation (TMS) modulates the brain’s electrical environment using magnetic fields, which pass through the scalp and skull unimpeded. These fields are produced by passing rapidly alternating electrical currents through a coil. The magnetic field strength produced by TMS is comparable to an MRI device, except that it focuses on a limited area of the cortex using a circular, figure-eight, conical, or helmet-like coil design (eg, H-coil).
What does TMS treat?
TMS is FDA cleared to treat 'treatment-resistant depression' and anxiety.
​
TMS is also used to treat obsessive compulsive disorder (OCD), ringing in the ears (tinnitus), and substance abuse disorders.
1) Cohen, S. L., Bikson, M., Badran, B. W., & George, M. S. (2022). A visual and narrative timeline of US FDA milestones for Transcranial Magnetic Stimulation (TMS) devices. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation, 15(1), 73-75.
Is TMS safe?
1) Rossi, S., Antal, A., Bestmann, S., Bikson, M., Brewer, C., Brockmöller, J., ... & Hallett, M. (2021). Safety and recommendations for TMS use in healthy subjects and patient populations, with updates on training, ethical and regulatory issues: Expert Guidelines. Clinical Neurophysiology, 132(1), 269-306. 2) Stultz, D. J., Osburn, S., Burns, T., Pawlowska-Wajswol, S., & Walton, R. (2020). Transcranial magnetic stimulation (TMS) safety with respect to seizures: a literature review. Neuropsychiatric disease and treatment, 2989-3000.
TMS has proven to be very safe. TMS is essentially an MRI that is focused to a very specific part of your brain.
​
Certain precautions are taken to ensure you don't have any metal or other implants in your head as they could be affected by the magnetic field that is produced during treatment.
​
Risk of seizure is 0.1%. TMS is used with caution in those with a history of seizure. Our psychiatrist will determine if you can safely undergo TMS depending on your seizure history.
Is TMS effective?
1) Davila, M. C., Ely, B., & Manzardo, A. M. (2019). Repetitive transcranial magnetic stimulation (rTMS) using different TMS instruments for major depressive disorder at a suburban tertiary clinic. Mental illness, 11(1), 1-8.
A study of 247 individuals evaluated the effectiveness of TMS for depression. Following 30 sessions of TMS, 72% of individuals experienced a remission from their symptoms of depression. Interestingly, those with past suicide attempts, previous psychiatric hospitalizations, and substance use disorder had a higher response rate, illustrating that the procedure was highly effective for individuals with severe and/or comorbid disease.
Is TMS approved by the FDA?
Yes. In 2008, the FDA approved TMS to treat major depressive disorder. In 2018, it was approved to treat obsessive compulsive disorder (OCD). Trials are also investigating the efficacy of TMS in the treatment of substance use disorders with alcohol, opioids, cannabis, tobacco, methamphetamine, and cocaine.
1) U.S. Food and Drug Administration. FDA Permits Marketing of Transcranial Magnetic Stimulation for Treatment of Obsessive Compulsive Disorder. Available at https://www.fda.gov/news-events/press-announcements/fda-permits-marketing-transcranial-magnetic-stimulation-treatment-obsessive-compulsive-disorder. Last accessed Feb 8, 2024. 2) Mahoney III, J. J., Hanlon, C. A., Marshalek, P. J., Rezai, A. R., & Krinke, L. (2020). Transcranial magnetic stimulation, deep brain stimulation, and other forms of neuromodulation for substance use disorders: Review of modalities and implications for treatment. Journal of the neurological sciences, 418, 117149.
Is TMS covered by insurance?
In most cases, YES! We work with you and your insurance company to preauthorize your treatment.
What are the advantages of TMS over other therapies?
Advanatges of TMS​:
-
TMS is effective in patients who fail to respond to antidepressant medication.
-
Unlike electroconvulsive therapy (ECT), TMS is an office-based procedure that requires no anesthesia or sedation.
-
Unlike ECT, TMS causes no cognitive side effects.
-
Unlike medications, TMS causes no systemic side effects such as weight gain or sexual dysfunction.
-
Unlike medications, which are prone to patient error and non adherence, TMS is an observed procedure during which the clinician can ensure proper administration.
1) Bermudes, R. A., Lanocha, K. I., & Janicak, P. G. (Eds.). (2017). Transcranial magnetic stimulation: clinical applications for psychiatric practice. American psychiatric pub.