TMS
What is TMS?
Transcranial Magnetic Stimulation (TMS) is a well-tolerated, non-invasive, procedure that uses electromagnetic energy to stimulate the brain. It has been FDA-approved since 2008 for the treatment of major depression.
Over the past few years, Obsessive Compulsive Disorder (OCD) for TMS have been approved by the FDA.
TMS treatments vary anywhere from 15-40 minutes depending on the treatment protocol. After treatment, patients are able to return to their usual daily / work activities. There are no negative effects on cognition, meaning that the patient’s memory and thinking capacity has not been shown to worsen from TMS treatments. A typical treatment protocol for depression requires 5 treatments per week for 6 weeks, followed by 6 tapered treatments 2 times a week for the last 3 weeks, a total of 36 treatments in 9 weeks.
How Does TMS Work?
TMS uses focused magnetic pulses similar to that produced by a magnetic resonance imaging (MRI) Machine. The magnetic field is most commonly used to stimulate a part of the brain called the left dorsolateral prefrontal cortex (the most common treatment site for depression). This part of the brain is involved with mood regulation and is less active in depression. TMS restores this neurocircuit to a more normal, non-depressed level of functioning.
Other treatment sites have been used for depression as well as other conditions.
Who Is a Good Candidate for TMS?
Patients who have not benefited from antidepressant medications, who have concerns about the side effects of medications, or who are unable to take medication are good candidates for TMS.
Side Effects of TMS
The most common side effect(s) from TMS are transient irritation on the scalp at the treatment site and/or a mild headache. Most people do not have these symptoms after the first week of treatment. Since TMS is non-systemic treatment, meaning that it does not affect any organ in the body except the brain, it does not have the side effects common to antidepressant medications such as weight gain, dry mouth, nausea, sexual dysfunction, drowsiness, or increased anxiety.
What To Expect from Treatment
Patients are awake and alert; there is no need for anesthesia or sedation.
The treatment takes place in our outpatient office. In the room, the patient will be seated comfortably in an adjustable chair.
During the first session, several head measurements are taken to determine the amount of energy needed to activate the patient’s brain waves, which is known as the motor threshold. The treatment coil is then placed on the designated treatment site, which typically is the left dorsolateral prefrontal cortex for depression.