Transcranial Magnetic Stimulation (TMS)

Transcranial magnetic stimulation (TMS) is a non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain. It is primarily used to treat depression and certain other conditions, including anxiety, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD).

How TMS Works

TMS involves the use of a magnetic coil placed on the scalp, which generates a magnetic field that can penetrate the skull and reach the brain. This magnetic field induces electrical currents in specific areas of the brain, stimulating or modulating neuronal activity.

Types of TMS

• Single-pulse TMS: uses a single pulse of magnetic energy to stimulate the brain.
• Repetitive TMS (rTMS): uses repeated pulses of magnetic energy to stimulate the brain, often used for therapeutic purposes.
• Theta-burst stimulation (TBS): a form of rTMS that mimics the brain's natural theta-wave activity.

Therapeutic Applications

TMS has been FDA-approved for the treatment of:

• Treatment-resistant depression: TMS can help improve mood and reduce symptoms in patients who have not responded to other treatments.
• Obsessive-compulsive disorder (OCD): TMS has been shown to reduce symptoms of OCD, including obsessive thoughts and compulsive behaviors.

Risks and Side Effects

Common side effects of TMS include:

• Headache
• Scalp discomfort
• Fatigue
• Seizure risk: although rare, TMS can induce seizures in some individuals.

Contraindications

TMS is not recommended for individuals with:

• Pacemakers or other implanted metal devices
• History of seizures or epilepsy
• Pregnancy or breastfeeding: the safety of TMS during pregnancy and breastfeeding has not been established.

Procedure and Treatment Course

A typical TMS treatment course consists of:

• Initial consultation: to determine if TMS is suitable for the individual.
• Treatment sessions: typically 30-60 minutes, 3-5 times per week, for 4-6 weeks.
• Follow-up appointments: to monitor progress and adjust treatment as needed.