WHAT IS TMS?
TRANSCRANIAL MAGNETIC STIMULATION
TMS, or transcranial magnetic stimulation, is a non-invasive, first-line option for treatment-resistant depression. It uses magnetic pulses to stimulate the left dorsolateral prefrontal cortex, or DLPFC, which helps to improve neuroplasticity and baseline activation levels. This area has been heavily implicated in depressive symptoms through years of neuroimaging research.
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In a TMS treatment, you sit in a chair with a magnetic coil positioned near your scalp that emits a light stimulation that feels like a tapping sensation. A session of repeated magnetic pulses usually lasts from 20 to 30 minutes. Sessions are usually repeated 5 days a week for a total of 30 to 36 sessions. This repetitive stimulation over the course of a 7-8 weeks improves neuroplasticity, reactivates the left DLPFC, and improves depressive symptoms such as low mood, poor motivation, and poor focus.
During this process, the patient has 22 sensors placed on the head, and the brain’s electrical activity is recorded for 20 minutes. This data is then edited and quantitatively analyzed, which leads to two- and three-dimensional images of brain activity. A qEEG assessment can help ensure that TMS is a good fit for each patient, and it can help to reduce potential negative side effects.
HOW EFFECTIVE IS TMS?
At NCFWC, we use an Apollo TMS system, which uses a figure eight coil. This is the most advanced type of TMS stimulation unit on the market. It has been approved for the treatment of depression, anxious depression, and OCD. In addition, the figure eight allows for a more concentrated area of stimulation, which helps to improve efficacy. The Apollo also uses advanced target placement to ensure that the exact area is stimulated
each and every session.
Unlike electroconvulsive therapy, or ECT, TMS does not require sedation, so the patient can drive home after the treatment. During TMS treatment, we recommend that patients continue taking their medication as normal. We will monitor medication throughout the process and recommend changes when appropriate. In addition, it is important for patients to continue working with their therapist on cognitive and behavioral goals throughout treatment, especially as the neuroplasticity begins to improve.
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Statistics and research on the efficacy of TMS vary based on a number of factors including prior neuroimaging, number of sessions, type of coil, and frequency of sessions. In most programs, the remission rate for depression is 60%, and the response rate is 80%. This is why TMS is referred to as a front-line treatment for depression.
One method, pioneered at Stanford university referred to as the SAINT protocol, achieved an 80% remission rate.
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WHO CAN BENEFIT FROM TMS?
Treatment-resistant depression
OCD & Anxiety
