What is TMS Therapy?
TMS stands for transcranial magnetic stimulation, a treatment for depression. TMS is not to be confused with ECT (Electroconvulsive therapy). TMS uses a different approach that is FDA-approved, non-invasive and has few side effects. It uses pulses of magnetic energy to stimulate specific areas of the brain and improve its function. Patients are awake and able to drive to and from treatments that are done in the office. The typical course of treatment is about 50 minutes daily, 5 days a week, over 6-7 weeks.
TMS Therapy uses short pulses of magnetic energy to stimulate the area of the brain that research has demonstrated to be associated with depression. The stimulation results in changes that improve the function of brain networks and provide relief of symptoms.
The History of TMS
Transcranial Magnetic Stimulation (TMS therapy) was FDA approved to treat depression in 2008 and was approved later for the treatment of migraine headaches. In 2018, the FDA approved a new protocol to treat depression, Thetaburst TMS, and also approved the use of TMS in the treatment of Obsessive-Compulsive Disorder. Several other conditions have been researched and successfully treated using TMS, “FDA off-label” protocols. Insurance covers TMS for depression in patients who meet their specific criteria but usually does not cover conditions other than depression.
Other Conditions Treated with TMS
Other conditions that have been researched and successfully treated using TMS are depression associated with bipolar disorder, PTSD, Smoking cessation, substance use disorders, tinnitus, stroke
rehabilitation, autism spectrum disorder, Alzheimer’s disorder, borderline personality disorder, and others. One might wonder how TMS could be helpful in so many conditions? TMS is helpful in several conditions because it affects various networks of the brain, depending on what part of the brain is stimulated, and what stimulation protocol is used.
The FDA approved thetaburst TMS in 2018, a new form of TMS in which the physics of stimulation is much more efficient. In other words, it takes fewer magnetic pulses and a shorter period of time to be effective. Some research suggests that in the future it may prove to be more effective than older TMS protocols, and it may make it feasible to treat several areas of the brain in each session. Genesis Behavioral Health has upgraded its equipment and is treating patients with thetaburst TMS.
Improving TMS Success Rates
Research is ongoing to improve the success rates with TMS. One of the strategies being researched is Neuro-Cardiac-Guided TMS. An interesting phenomenon occurs when the brain is stimulated in the location used for the treatment of depression: the heart rate temporarily slows a few beats per minute. Although larger research studies are needed to confirm that using this method to more accurately target the best treatment location is clinically useful, it may be a means of improving success rates.