What is Transcranial Magnetic Stimulation? (TMS)
Transcranial Magnetic Stimulation (TMS) is a non-invasive treatment option (FDA approved) for depression, OCD, and smoking addiction. TMS delivers magnetic stimulation to the brain through a helmet containing coiled magnets which send a series of inductive electrical currents to specific target areas in the pre-frontal cortex in the brain. TMS has been shown to safely and effectively regulate the neural activity of brain structures that are associated with depression, OCD, and other mental illnesses. TMS is typically used when other depression treatments have failed to improve symptoms.
There are two types of TMS: repetitive transcranial magnetic stimulation (rTMS) and deep transcranial magnetic stimulation (dTMS). Both dTMS and rTMS are more specific ways of referring to same TMS therapy treatment option. However, they differentiate the technology used to deliver TMS therapy and the depth magnetic pulses activate in the brain. At Coral Mountain Behavioral Health, we provide dTMS developed by BrainsWay as it delivers stimulation in the deeper structures of the brain.
Standard rTMS vs dTMS
In rTMS, the machine helmet contains a figure-eight shaped magnetic coil that sends out electromagnetic pulses about 1.5cm into the brain to stimulate neurons that, in turn, stimulate activation of neurons in the deep brain. Although rTMS is a safe and effective treatment option, the narrow activation depth limits the treatments ability to stimulate deeper neural structures directly.
In dTMS, the machine helmet improves on the figure-eight coil design with a patented H-coil that sends out electromagnetic pulses about 4cm into the brain to activate deep brain neurons directly. dTMS received FDA approval in 2013 for treating depression, in 2018 for treating OCD, and in 2020 for the treatment of smoking addiction. dTMS is the first and only non-invasive device FDA approved for the treatment of OCD and is the first TMS device to FDA approved for the treatment of addiction.
While the magnetic coils and technologies used are slightly different, both have shown to be highly effective in treating major depression (1).
Is TMS right for me?
At Coral Mountain Behavioral health, we utilize Dr. Lisa Fraleigh’s decades of clinical psychiatric experience to ensure you have the best evidence-based treatment plan that is unique to you.
TMS is typically considered for those who have treatment resistant depression or OCD. It is also the best alternative for those who struggle to manage the side effects of prescription medications. TMS can easily be integrated into your daily schedule, is well-tolerated without adverse or long lasting side effects.
You might consider TMS if…
You have tried multiple prescription medications for depression or OCD and haven’t tolerated side effects or seen improvement in symptoms
You need to drive yourself to and from treatment sessions (you must have another person to drive you to and from ketamine therapies)
You need a shorter treatment session (TMS is typically 20-45 minutes whereas ketamine therapies are a minimum of two hours)
Who should not consider TMS?
Individuals with any type of ferromagnetic metal in their heads including aneurysm clips or coils, stents in the neck or brain, implanted electrodes, deep brain stimulators, and metal plates or metallic implants. Note: Braces, dental fillings, or titanium are OK
If you are still unsure which mental health treatment is best for you, give us a call and make an appointment and our providers will work with you to develop a treatment plan that is unique to you.
References
Wirecki T, Stephenson M, Rebecca Seale, et al. A comparison of rTMS and dTMS treatment outcomes for major depressive disorder in a real-world clinical practice setting. Brain Stim J. Sept-Oct 2015;8(5):e6.