What Is Transcranial Magnetic Stimulation (TMS)?

Transcranial magnetic stimulation (TMS) therapy is an innovative mental wellness treatment that uses gentle magnetic pulses to stimulate nerve cells in certain brain areas, causing pronounced changes in mood and behaviour. TMS is a National Institute for Health and Care Excellence (NICE) approved treatment for depression and an evidence-based treatment option for a range of mental health concerns.

TMS can be a lifeline for clients who have not responded to other treatment options, offering long-lasting change with few side effects. It is usually an outpatient procedure involving short, daily sessions over six to nine weeks, so you can fit TMS around your everyday routine.

What Is Repetitive Transcranial Magnetic Stimulation (rTMS)?

Repetitive transcranial magnetic stimulation, as opposed to single-pulse TMS, involves trains of repetitive magnetic pulses. Almost all mental health treatments use repetitive TMS.

What Is Deep Transcranial Magnetic Stimulation?

Deep transcranial magnetic stimulation uses special combinations of magnetic coils to reach broader, deeper areas of the brain. It uses “H-coils” to induce magnetic energy that can reach at least 4cm below the skull without having to increase the intensity of the magnetic pulse.

The development of deep TMS has expanded the application of TMS therapy, stimulating areas of the brain involved in a wider range of mental health conditions.

How Does TMS Therapy Work?

People living with mental health conditions often have increased or decreased activity levels in certain brain areas. Some areas of brain cells may communicate at a faster rate than is normal, while others may function more slowly. These abnormal activity levels can affect mood and behaviour, making people feel low or anxious.

During TMS treatment, a magnetic coil is placed over the client’s head. Electricity passes through the coil, generating a series of magnetic fields that pass through the scalp and induce very small electric currents in the target brain cells. The electromagnetic coil produces trains of repetitive magnetic pulses that stimulate neuronal activity in the desired brain areas.

What Conditions Can TMS Treat?

TMS is an effective treatment for a range of mental health disorders, including major depression, general anxiety disorder, post-traumatic stress disorder, obsessive-compulsive disorder, attention deficit hyperactive disorder, bipolar disorder, and addiction.

TMS for Major Depressive Disorder

TMS was first developed as a treatment for major depressive disorder. Research has found that applying rTMS treatment to the dorsolateral prefrontal cortex can improve depression symptoms in over 50% of clients, including those who have not responded to other depression treatments. It also has fewer side effects than antidepressant medications and other treatment approaches.

TMS was cleared by the FDA for treatment-resistant depression in 2008 and by NICE in 2014.

TMS for Anxiety Disorders

Clinical trials have shown TMS to be effective in treating a range of anxiety disorders, including general anxiety disorder (GAD) and post-traumatic stress disorder (PTSD). In 2021, the FDA approved deep TMS as a safe and effective treatment for obsessive-compulsive disorder.

Recent research suggests that high-frequency magnetic stimulation on the right dorsolateral prefrontal cortex may offer the most effective results; however, high and low frequencies on both sides of the brain can be effective.

TMS for Bipolar Disorder

TMS can have a life-changing impact on the recovery of clients living with bipolar depression. A final report by Brainways found that deep TMS can produce a response in 70% of clients. Another clinical trial found that TMS can improve cognitive functions across 6 domains – attention and processing speed, working memory and executive function, inhibitory control, language, immediate verbal memory, and long-term verbal memory.

TMS for Addiction

Research shows that TMS is an effective treatment for several types of substance and behavioural addiction.

Studies have found that, when offered as part of an alcohol addiction treatment program, TMS can reduce alcohol consumption and increase days of abstinence. Randomized clinical trials have shown that TMS can effectively treat nicotine addiction and aid smoking cessation.

TMS can work alongside talk therapies, support groups, and other treatment approaches to provide long-lasting and holistic recovery from substance abuse.

TMS for Traumatic Brain Injury

Recently, TMS research has expanded from the realm of psychiatric disorders to investigate the efficiency of TMS as a treatment for traumatic brain injury.

A 2021 “scoping review” found that TMS has the potential to be an effective treatment for many of the after-effects of traumatic brain injury, including depression, dizziness, central pain, and visual neglect. Another study concluded that TMS was a promising tool for diagnosing traumatic brain injury and supporting motor recovery, communication, and visual-spatial functions.0p

transcranial magnetic stimulation

What Happens In a TMS Session?

During a rTMS therapy session, your TMS physician will place the magnetic coil over your head and send out a series of magnetic pulses. The therapy session should last between 20-40 minutes and you can communicate with the physician throughout. During the treatment, you may hear a clicking sound and experience a tapping sensation beneath the coils.

What Is a “Mapping Session”?

Your first session, the mapping session, will be a little longer than the rest of the treatment sessions. During the mapping session, the physician needs to locate the target brain cells and determine your motor threshold.

The physician will begin by moving the magnetic coil over your head, sending out single magnetic pulses until they notice a twitch in your right hand. This means they have located the motor cortex, an area of the brain involved in many important functions including muscle movements.

Having located the cortex, they will send out pulses of decreasing intensity until they no longer notice a twitch. This is your motor threshold.

Using these measurements, the physician can determine the correct placing of the coils and the optimum intensity of the magnetic pulse. They may mark the location on a white cap for use in future sessions.

Does TMS Have Any Side Effects?

Transcranial magnetic stimulation (TMS) has few side effects, especially compared to pharmacotherapy treatments such as antidepressants.

Common side effects of TMS include:

  • mild headaches
  • scalp discomfort
  • muscle twitching
  • jaw pain

These side effects are only temporary and often decrease over the course of treatment. Your TMS technician may be able to reduce discomfort by adjusting the positioning and stimulation settings of the rTMS machine.

TMS comes with a low risk of seizure, but the risk is less than or comparable to other depression treatments including antidepressants.

TMS is not associated with any long-term, systematic side effects that may develop with medication such as weight gain and sexual dysfunction.

How Long Is A Standard Course of TMS Therapy?

A standard course of TMS involves daily treatment sessions for four to six weeks, followed by three weeks of tapering off sessions.

However, TMS schedules may be flexible. Research shows that it’s the number of sessions that’s important and changing the frequency of sessions does not affect its clinical effectiveness. A 2008 study found that twice-daily sessions were as effective as once-daily, potentially reducing the duration of a treatment course.

You can talk to your TMS provider to find the optimal TMS schedule for your needs.

How Long Do the Effects of TMS Last?

Research shows that the benefits of TMS therapy can last for a year after the completion of a standard treatment course.

A 2018 study on TMS clients living with major depressive disorder found a sustained positive response in 50% of clients a year after treatment. A real-world study into the efficacy of TMS for OCD showed that 52% of clients exhibited improved symptoms a month after they completed their program.

Some clients also participate in maintenance sessions to enhance the durability of TMS. Maintenance treatments may consist of two days of sessions each month, one session every two weeks, or some other schedule. You can work with your mental health provider to find to optimum program for you.

What Are Brain Stimulation Therapies?

Brain stimulation therapies use electricity to stimulate certain areas of the brain and may contribute to the treatment of mood and behavioural disorders. There are several types of brain stimulation therapy, including:

  • electroconvulsive therapy
  • deep brain stimulation therapy
  • vagus nerve stimulation
  • magnetic seizure therapy
  • transcranial magnetic stimulation therapy

Brain stimulation therapies may be of the invasive or noninvasive form:

  • invasive therapies usually involve placing metal implants (such as deep brain stimulators) into the patient’s head and require anaesthesia
  • non-invasive therapies do not require surgery or anaesthesia

TMS is a non-invasive brain stimulation therapy, meaning that the equipment does not pierce the scalp. Unlike some other therapies which deliberately induce seizures, TMS is painless and has few side effects. The risk of seizure is low – comparable to or less than that of other antidepressants.

Is TMS For Me?

For many people, TMS is a life-changing treatment – especially for clients who have not responded to other recovery approaches. If you are looking for a treatment to revolutionize your recovery journey, TMS could be for you.

At Addcounsel, we recognize that it can be scary to try something new. You still may have questions and apprehensions. We encourage you to contact us for a personal consultation where we can share our expertise and offer a thorough assessment of whether TMS is a safe and suitable option for you.

Mental Health Services at Addcounsel

Addcounsel offers private and exclusive recovery services for a range of mental health and behavioural concerns. We offer a world-class selection of treatment approaches, tailored to each client’s unique needs. We believe that you deserve the very best – it’s our duty to determine and deliver the best recovery program for you.

At Addcounsel, we offer a one-client-at-a-time approach for clients living with mental health and substance use disorders. Our exceptional team of clinical experts work alongside compassionate support staff to deliver our programs to each client. We work with integrity, offering full confidentiality and privacy to each client.

Our treatment programs follow a whole person recovery approach that focuses on the multiple needs of each individual. We encourage meaningful, long-lasting change that supports each client to overcome internal struggles and reach their full potential.

We offer treatment from our luxury rehab facilities in central London or as a visiting service to your home. We’re here to listen to your needs and devise a schedule that suits you.

Exclusive Arabic Services

For Arabic speaking clients, we deliver our services in the Arabic language, ensuring a deep and direct connection between our staff and each client. Connection and understanding are two of the most important foundations of mental wellness – we ensure that our recovery team are sensitive and empathetic to your needs.

We understand the cultural differences and diversity in attitudes towards addiction and mental health concerns and work with some of the most qualified experts and clinical staff from Arabic speaking nations to provide the best possible service.

Every client is treated without judgement, with confidentiality, and with the highest respect.

Contact Us Today

If you are interested in TMS therapy or other mental health services, contact us today. We’re here to help.

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