Transcranial Magnetic Stimulation
Nerve cells in the brain
| Download this episode | Transcranial magnetic stimulation, or TMS, involves the use of a very short pulsed magnetic field to stimulate nerve cells in the brain. When treating a major depressive disorder, TMS therapy is targeted at an area of the brain that is underactive in depression. The TMS procedure is done on an outpatient basis, performed while the patient sits comfortably in a chair. With TMS, there are none of the side effects commonly associated with antidepressant medications. TMS was approved by the U.S. Food and Drug Administration in 2008 for the treatment of depression and has been shown to be effective in helping those patients who have failed to benefit from antidepressant drugs and psychotherapy. It is estimated that between 50 and 60 percent of individuals with TRD, or treatment resistant depression, who have failed to see any improvement through the use of medication management and psychotherapy will have a positive response to TMS. | Transcranial magnetic stimulation, or TMS, is a non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. TMS is typically used when other depression treatments haven’t been effective. During a TMS session, an electromagnetic coil is placed against the patient’s scalp near their forehead. The electromagnet painlessly delivers a magnetic pulse that stimulates nerve cells in the region of the brain involved in mood control and depression. It’s thought to activate regions of the brain that have decreased activity in depression. Though the biology of why TMS works isn’t completely understood, the stimulation appears to impact how the brain is working, which in turn seems to ease depression symptoms and improve mood. There are different ways to perform the procedure, and techniques may change as experts learn more about the most effective ways to perform treatments. | Depression is a treatable condition, but for some people, standard treatments aren’t effective. Transcranial magnetic stimulation is typically used when standard treatments such as medications and psychotherapy don’t work. Dr. Lou Ann Eads, the head of UAMS’ Interventional Psychiatry program, says unlike other forms of treatment, TMS doesn’t require anesthesia or any medication adjustments prior to or after the treatment. TMS is a safe procedure that most patients find easy to tolerate, although it can cause some side effects. Dr. Eads says the most common side effects include mild headaches, lightheadedness and scalp discomfort. These side-effects are generally mild and usually resolve after a few treatments, if they develop at all. If a headache develops, the patient may be advised to take an over–the–counter pain medication before coming for the procedure. However, this is usually only needed during the first few treatments. | Before undergoing your first session of transcranial magnetic stimulation, your physician will need to identify the best place to put the magnets on your head and the best dose of magnetic energy for you. You’ll then be taken to the treatment room and asked to sit in a reclining chair. An electromagnetic coil will be placed against your head and switched off and on repeatedly to produce stimulating pulses. This results in a tapping or clicking sound that usually lasts for a few seconds, followed by a pause. You’ll also feel a tapping sensation on your forehead. This part of the process is called mapping. Your doctor will determine the amount of magnetic energy needed by increasing the magnetic dose until your fingers or hands twitch. Known as your motor threshold, this is used as a reference point in determining the right dose for you. During the course of treatment, the amount of stimulation can be changed, depending on your symptoms and side effects. | Like any kind of treatment for depression, transcranial magnetic stimulation has its positive and negative aspects. Before beginning any therapy, the patient should talk with his or her doctor or therapist. Each patient is different and what works for one may not work for another. TMS is used on the patient who has not responded to medication when treated for depression. Many mental health professionals report promising results from this treatment. The TMS procedure is not recommended for patients who have a history of seizures. Those who have a metal plate in their head, or any other metal in and around their head should not have the procedure done. Braces and fillings will not interfere with the treatment. Doctors say that the patient often experiences relief from TMS within two to four weeks. Depending on the patient’s outcome, follow-up sessions may be recommended every few weeks or months to help maintain the positive results.
Transcript
Non-invasive procedure
Transcript
A treatable condition
Transcript
A tapping sensation
Transcript
Talk to your doctor first
Transcript