Transcranial Magnetic Stimulation or TMS sends electromagnetic currents near the frontal lobe of the brain to stimulate brain activity. The medical community had used brain stimulation for years as an effective treatment for various psychiatric disorders, especially depressive and anxiety disorders.
As a non-invasive medical procedure that uses a magnetic field to stimulate nerve cells in the brain, it remains one of the safest therapies to treat various health problems. Due to its efficiency and effectiveness, recent studies had explored other possibilities of TMS therapy to other types of health problems like addiction.
The US Food and Drug Administration of FDA approved TMS as a safe and alternative treatment for depression. Today, more scientists explore the possibility of other medical uses of TMS.
The Study Behind the Theory
The results show a promising clinical data indicating that TMS can help people recover from addiction. Neuroscientists Antonello Bonci and Billy Chen from the National Institute on Drug Abuse (NIDA) in Baltimore spearheaded a study of rats trained to uncontrollably seek out cocaine. The rats are very much addicted that they tolerate electric shocks just to get their fixes. However, when researchers stimulated the rat’s brain using TMS, the animals were able to get out of their addiction.
In a journal published in Nature, Bonci and other scientists suggested that stimulating the prefrontal cortex can help addicts end their substance abuse. TMS can effectively target that area of the brain. As a non-invasive procedure stimulating neural activity, it might help with addiction.
There are several more studies conducted each year to support TMS therapy as a safe and effective alternative treatment method for various illnesses.
During TMS procedure, an electromagnetic coil is placed on the scalp near the forehead. The electromagnet delivers a magnetic pulse to stimulate nerve cells in the brain associated with controlling mood and depression – the two main emotional factor triggering addiction.
Repeated Transcranial Magnetic Stimulation
Repeated Transcranial Magnetic Stimulation (sometimes referred to as rTMS) uses a coil that emits a magnetic wave that passes through the skull. This triggers an electrical field that can alter brain cells activity. This varies from low frequency about 1 hertz to a high frequency of 10 to 20 Hertz. Health care professionals study the strength based on the patient’s motor threshold, which is the needed amount of current that makes fingers or leg muscles move when a TMS session starts.
This procedure had been proved effective for treating depression. TMS affects the prefrontal cortex of the brain, which affects the limbic system, an area of the brain associated with addiction. Stimulating and regulating brain nerve cells in these parts can help decrease symptoms of addiction.
The subcortical generally the medial prefrontal cortex, modulates addiction but needing deeper stimulation using rTMS. Studies show that using H-coil and higher frequency stimulation with 120% motor threshold will yield better results.
According to the American Psychiatric Association, TMS show positive promise as an alternative addiction treatment.
Digging Deeper into the Brain
Still, TMS research needs to dig deeper into the brain to targets more areas of the brain. Usually, doctors use “figure 8 coil” but others use “H coil” which can reach deeper parts of the brain.
Scientists have tested the theory on nicotine dependence, one of the most studied forms of addiction. On several research studies, stimulating the dorsolateral prefrontal cortex, (DLPFC) using “figure 8 coil” eventually decreases nicotine cravings. However, other studies show that nicotine dependence was totally eliminated. In alcohol dependence, TMS used in high-frequency targeting DLPFC showed promising effect.
Different studies consistently show TMS as a safe and effective tool for addiction treatment that carries no significant side effects.
More than 14 million American adults suffer from clinical depression. According to researchers, by the year 2020, depression will be the second leading cause of disability in the world. Around two-thirds of people suffering from depression will have another episode of the illness during their lifetime. Existing treatment options often lead to severe side effects. In time these medications will lose their effectiveness in treating depression. These will eventually lead to a lack of adequate treatment options.
What is Transcranial Magnetic Stimulation or TMS?
Transcranial Magnetic Stimulation or TMS is a newly found advance treatment for resistant depression. The US Food and Drug Administration of FDA approved TMS for clinical depression that can no longer treat with previous conventional antidepressant medications and therapies. Patients who suffer from drug-resistant treatments and medications can benefit well undergoing TMS therapy.
The medical community approved TMS because of its non-invasive procedure. TMS does not require any sedation, anesthesia on its depression treatment. It’s a simple procedure which conveniently performed right inside the doctor’s office under their supervision. Patients are kept awake and fully alert during each treatment sessions.
As a non-systemic and does not include heavy doses of drugs. Also, because TMS is a non-pharmaceutical therapy, it does not entail any drugs to circulate throughout the body. Since TMS does not involve any medical procedure or drugs, it does not have side effects associated with antidepressant medications like weight gain, nausea, sleepiness, memory loss, and sexual dysfunction.
Initially, TMS was used as depression treatment but recent studies show that this procedure can also treat different brain disorders. Doctors used TMS to treat a wide range of mental disorders like generalized anxiety, obsessive-compulsive disorder (OCD), tinnitus and cognitive impairments.
Some of the benefits of TMS include:
TMS active a large area of the Prefrontal Cortex
TMS delivers highly focus magnetic field pulses to the prefrontal cortex of the brain – to stimulate the area of the brain associated with depression. The procedure produces short bursts of magnetic pulses through the scalp and it triggers the neurons locally as it targets the areas of the brain. The pulses which the TMS machine produces are similar to what the MRI imaging scan emits. As the TMS machine produces these pulses, it stimulates the deeper and broader area of the brain linked to depression.
An effective depression treatment
Many can attest to the excellent efficacy of TMS therapy. Several studies support the effectiveness of this state of the art technique. During the 4 to 8 weeks of TMS treatment phase, clinically depressed people show a promising recovery that persists into the long term. The success of TMS treatment grows steadily over the years as newer treatment parameters have been discovered along with strategic targeting in the brain’s area. Even for people who undergone electroconvulsive therapy or ECT, they show significant recovery from depression.
Shorter treatment time
The average treatment for TMS therapy lasts for about 4 to 8 weeks. During this time, patients can already notice great improvements in their overall well-being. Studies show that the improvements noted in the patient lasted for several years without any significant relapse. This saves a lot of time and money for both the providers and the patient. Compare to antidepressant medications and therapies, TMS offers a safe and effective treatment for depression.
Other Benefits of TMS
Unlike the conventional depression treatments, TMS therapy does not produce systemic side effects like sedation, nausea, weight gain, sexual dysfunction, dry mouth. There are no reports of either memory loss or inability to concentrate which are both links to antidepressants.
Several clinical trials show that TMS therapy is an effective and safe treatment for patients who do not respond to previous antidepressant medications. TMS therapy offers very few side effects which are generally well tolerated by most patients. The most common side effect of TMS includes a slight scalp irritation and mild headache during the first week of treatment but will eventually subside.
Bipolar Disorder is a brain disorder that affects your mood in extreme ways. One moment you’re feeling alright, then you’re hit with an immense depression. In some cases, you feel incredibly happy, active and energetic and what’s odd is that you don’t remember when it started. Then comes this sudden tug of hopeless void, sometimes enough to make you faint on the spot.
This is not a way to live a healthy life and people with Bipolar Disorder struggle to live their everyday lives. There are effective medications to stabilize your moods, as well as psychotherapy. However, they have their setbacks such as time, costs, and physical conditions that can get in the way of medication. These were the only working methods until Transcranial Magnetic Stimulation was utilized.
TMS for Bipolar Disorder
Transcranial Magnetic Stimulation (TMS for short) is the process of placing an electromagnetic coil over your head and delivering precise electromagnetic waves to your brain. Specific parts of the brain are stimulated over a period of time, normally lasting around 10-20 minutes at a time. TMS is already a proven treatment for Severe Depression, so researchers are looking into how it affects people with Bipolar Disorder.
How TMS Works
How it works is that the coil delivers an electromagnetic wave to the brain. The affected area reacts to the waves, stimulating it. One such proof that it works is that when the magnet stimulates the motor area of the brain, the patient’s arm or leg twitches. The amount of energy delivered is not enough to harm the brain, even after repeated exposure.
The procedure is very much like physical therapy. Think of a part of your brain as an arm that hasn’t moved because it was in a cast. It’s frail and can’t bend much. In physical therapy, the therapist assists in moving the arm and making you grab objects. The same can be said for TMS therapy. The waves activate a specific part of the brain, making them “stretch and bend” like they used to. Depending on the frequency of the waves, TMS can either stimulate the part of the brain or suppress activity.
Treating Bipolar Disorder with TMS is slowly becoming a reality. Clinical trials have determined that using TMS to target areas of the prefrontal cortex show improvement in patients. To make the clinical trial more thorough, they set up two treatments. First is the sham or placebo test, literally therapy whose only purpose is to make the patient think they are getting treatment. The second is the true treatment, where the mood-center of the brain is stimulated.
Further Research Required
The end result of the clinical trials is conflicting. The placebo test yielded little improvements, which was good. On the other hand, the true treatment displayed improvement with patients. The only conflict is that the effects mostly leaned on improving the depressive effects. According to the “Hamilton Depression Rating Test”, TMS made significant improvements in the patients with Bipolar Disorder. This means though TMS has not fully treated the disorder, it made a significant improvement in their lives. It’s now just a matter of adjusting the treatment methods to further improve the results.
Autism is a complex condition in the brain which impairs communication and social interactions. It affects 1 out of 80 Americans on average, even more so when you consider the world. Autism has a lot of varied symptoms and severities that it’s called “Autism Spectrum Disorder” to help encompass all of it.
The cause of Autism is about as varied as its symptoms. In some cases, it’s caused by a faulty gene. In others, it caused by chemical imbalances or viruses during pregnancy, such as German measles. Autism is generally detectable around birth, up to the 3rd year of age. In some cases, a person may not display symptoms in the early years, only to dip in development after the 3rd year.
Today’s Autism Treatments
Treatment for Autism Spectrum Disorder is generally advanced methods of training. There are also drugs that help manage certain severities of autism like antipsychotics. Ultimately, once it’s detected, it should be given attention as soon as possible.
One problem is that for children and adolescents with severe conditions, treatment is extensive. It’s a long-term procedure that demands attention, both medical and financial. It impacts the quality of life of both the child and their parents.
There is promising hope for alternative treatment. It’s in a form of a special machine attached to an electromagnet. The procedure is called Transcranial Magnetic Stimulation, TMS for short. It uses electromagnetic waves to stimulate specific areas of the brain.
Transcranial Magnetic Stimulation Trials for Autism
The treatment is still in the experimental stage. There’s no government-approved methods yet, but clinical trials all over the world show promise. What makes transcranial magnetic stimulation a novel approach to brain treatment, is how simple the procedure is.
An 8-shaped magnet is placed on the patient’s head. Afterwards, the machine generates precise pulses of electricity that activates the electromagnet. This delivers a precise amount of electromagnetism into the brain, causing the targeted part to activate. The effect is both seen and felt during the testing and mapping phase. In this phase, the electromagnet will target the motor area of the brain, causing the hand or a foot to twitch when the magnet is activated.
How TMS Works to Treat Autism
How it works to treat Autism, is essentially the same way you learn how to do a certain task. TMS therapy will activate certain parts of the brain to “flex” them. The procedure lasts up to 6 weeks, with daily, 30-60 minute processes. With this repetitive process, the brain eventually learns to activate properly and all the parts around the area adapt accordingly. By aiming the electromagnet on the part of the brain that controls communication, it can train the area to work correctly.
Clinical trials have shown improvements in a child’s behavior. There’s improvement in social skills and hand-eye coordination, which are markers for progressive brain development. TMS therapy, combined with proper training could be the key to reversing the effects of Autism Spectrum Disorder.
It’s only a matter of time before a proper method of TMS therapy is approved. With promising results from clinical trials and the global effort of researchers, we’re one step closer to fully understanding our brain, and perhaps a cure for its many illnesses.
It’s perfectly normal to feel anxious, especially during times of stress or tension, such as the brief moment when your boss contemplates just after you asked for a raise. Anxiety is our brain’s way of preparing itself for danger. Not exactly to combat it, but to ensure that if we ever fight, or flee, our body is ready to act as best as it can.
When a person starts to feel anxiety outside where they should, problems start to arise. When anxiety occurs outside normal circumstances, and happens for days, over a course of more than 6 months, it’s classified as a disorder. The medical disorder is known as Generalized Anxiety Disorder, GAD for short.
It’s generalized because it has a number of causes, some of them unique to the person. It causes restlessness, fatigue, irritability, sleeping issues, and concentration problems, all of which make a significant dent in a person’s quality of life. What’s worse is that GAD is often accompanied, or causes other mental complications like depression.
Treatment via drug therapy is the most common solution, with counseling or Cognitive-Behavioral Therapy being the go-to for long-term treatment and recession prevention.
One downside to the otherwise effective ways to treat GAD is the high costs and the possible adverse effects due to the medication. If a person has good health insurance, that can be mitigated somehow, but not everyone has it.
Transcranial Magnetic Stimulation: A New Hope
As the procedure is called, Transcranial Magnetic Stimulation (TMS for short) is a relatively novel way to treat anxiety disorders. TMS was already in use decades ago in order to map out brain function in stroke patients. They figured that since our brain cells respond to weak pulses of electromagnetism, it could be used to stimulate brain cells to restore their function.
The idea is simple. An electromagnet is placed on top of your head and a machine regulates the electricity flowing to the magnet, creating minute pulses of electromagnetism. The targeted area of the brain is affected by the waves and they activate or at least react to the stimulation. Like physical therapy on a newly recovered leg or arm, the procedure will “train” and “massage” the target area of the brain to work back to normal. These procedures normally last about an hour and are done daily for 4-6 weeks.
The magnetic pulses are set to a low frequency of 1 Hz. Think of this as music. Lower Hz is slow, calm music while higher ones are the intense, fast beats. The low “hum” causes an inhibitory effect on the brain, calming activity as if listening to calming soul music. The pulsing is then aimed at the area of the brain where the cause of GAD is identified, such as the left prefrontal cortex. (The area above your left eye.)
The inhibitory effects showed remarkable results in reducing anxiety. Clinical trials with different experiments show consistent positive results, especially with continued TMS therapy. Currently, the only way to get TMS treatment for GAD is participating in clinical trials, but with solid evidence of improvement on patients, it’s only a matter of time before it’s approved as a treatment method.
A good number of people in the world hear sounds they shouldn’t be hearing. No, it’s nothing close to the supernatural. These people hear ringing or random sounds when there’s nothing that’s causing the noise around them.
This condition is called “Tinnitus” and it has a lot of causes. It could be due to serious issues such as brain damage and infection in the ear or could be as simple as a piece of dirt or ear wax lodged in your eardrum.
Though the causes can be identified, the mechanics behind Tinnitus is yet to be fully understood. There are cases where even if they managed to deal with the cause, the patient still hears random noises. This makes Tinnitus a symptom, rather than a condition on its own. Like a fever, you can treat it, but if you don’t deal with the actual problem, it will just keep coming back.
The most common cause of tinnitus is constant exposure to loud sound. Examples of these are constant exposure to construction noises or explosions. Construction workers and people who serve the military may be at risk of this. The cure is often to decrease the person’s exposure to loud noises. But, it doesn’t work for some people. Some people live with tinnitus for years. This can cause depression, anxiety, and concentration issues all their life.
Advancement in medical science have found a way to treat patients with long-term tinnitus. This process is through the simple use of electromagnets. The procedure is called “Transcranial Magnetic Stimulation.”
Transcranial Magnetic Stimulation Treatment for Tinnitus: How does it work?
Transcranial Magnetic Stimulation, or TMS, can be described as using a pair of electromagnets to stimulate certain parts of your brain using electromagnetism. It sounds simple, but that’s what makes it amazing. This procedure has little side-effects and shows direct results in treating Tinnitus.
During TMS therapy, the patient is sat comfortably in a chair and an operator will aim a number 8 shaped electromagnet an inch or two above the scalp. A machine connected to the electromagnet will deliver precise amounts of electricity. This causes the magnets to deliver pulses of electromagnetism.
The first step is to get you a physical and psychological exam. This is to ensure that you won’t have complications during the procedure and to understand your depression. When the physical exam checks out and the psychological evaluation is complete, you’ll be taken to the TMS clinic.
During the process, they will first “map out” the areas of your brain by activating the coil on certain areas of your head. You may feel a slight ticking in your scalp and your muscles may flinch, which is perfectly normal. When the doctor or operator has determined the right position, the machine will continue to send pulses to that specific part of the brain. I some cases, you may not feel any tapping or clicking sounds, but rest assured that the machine is doing its job.
After about 30-60 minutes of deep brain stimulation, the procedure ends for the day. Patients are highly encouraged to complete the entire procedure, lasting about 4-6 weeks to ensure that you get the best results.
The brain is perhaps the most complicated organ in the world. Millions of neurons communicating in countless ways. They work millions of times per second, all ensuring that you live longer than 2 minutes. Complicated systems also have complicated problems, which often need complicated solutions. Yet as we discover more about our brain and how we can affect it, solutions for problems such as depression, tend to get simpler.
So simple that it involves putting a magnet over your head for an hour or less, every day for a month.
What is TMS?
TMS is short for Transcranial Magnetic Stimulation. As the name states, it’s using electromagnets to stimulate areas beyond the skull, specifically, certain parts of the brain. The TMS machine consists of the electromagnetic coils that deliver the magnetic pulses and the pulse generator. This is a machine that delivers precise amounts of electric current to the magnet.
What is Depression?
It’s feeling sad, but not the everyday sadness you feel when you, for example, dropped your cold ice cream on hot, stressful day. Depression is an intense kind of sadness that can last for days, even weeks. It can affect your way of thinking, making it progressively worse. It can resolve itself into Clinical Depression, a treatable medical condition.
How Does it Work?
It works by activating a pair of electromagnetic coils about half an inch above your scalp. The two coils deliver a relatively weak pulse of electromagnetism, not enough to affect your brain in any significant way. Where the two waves meet, however, causes a significant electromagnetic effect. The effect is strong enough to make your hand or foot twitch when the coil is aimed at the motor area of the brain. Yet, weak enough that it doesn’t cause any significant damage, even after an daily, one-hour exposure over a month.
Using this targeted method, TMS can stimulate certain parts of the brain. People suffering from depression have decreased activity in certain parts of their brain. Specifically, these are the areas that create or govern the creation of Dopamine, a brain chemical that causes happiness. TMS can stimulate these areas to help restore normal function. Think of it as physical therapy on an arm or leg that has been cast for 4 months. TMS “flexes” and “massages” the problem areas, allowing these parts to work normally when they need to.
The full therapy varies depending on the severity of the depression. According to many clinical trials and anonymous patient data, 4-6 weeks of therapy caused improvements about 95% of the patients. The 5% are those unfortunate to have developed adverse effects. This is either through pre-existing conditions or could not handle the therapy due to side effects such as dizziness and nausea.
Continued therapy is encouraged well after the month-long procedure to minimize remission. Though there are still a number of patients who went into remission after stopping the procedure, TMS still holds a candle when it comes to non-invasive or drug therapies for depression.
Migraines are not your ordinary headaches. Sometimes, a headache is caused by a simple lack of sleep. Other times, it’s caused by stress. But what separates migraines from headaches is that they are severely painful and recurring.
An important factor that separates them is that Migraines often come with warning signs. In some people, their vision gets distorted somehow, becoming sensitive to light and sounds, or feeling intense nausea eventually leads to vomiting.
There’s no known single trigger for a migraine, but there are plenty of identifiable reasons that lead to migraine triggering. A majority of the “leads” are stress, food and drink, and sleep (specifically, lack thereof), which could also cause common headaches in some people. In some cases, it could even be feeling a certain emotion, such as feeling sad. There is no one cause, but there’s a whole range of solutions.
Medications works against migraines, but not everyone can tolerate meds and there are patients who get no benefit from those meds. Though the medication can be as simple as over-the-counter drugs, recurring pain can get in the way of normal life. The drugs don’t work 100% and in some cases only work briefly to “take the edge off”.
Transcranial Magnetic Stimulation for Migraines
That’s where TMS -Transcranial Magnetic Stimulation- is used for migraine treatment. The procedure is literally putting a magnet on your head. The statement alone can raise speculation, but it’s a bit more complicated than that.
Your brain triggers signals by using electricity. It’s been recorded that your brain uses around 20 volts electricity on average. Electromagnetism can deliver a harmless charge that activates neurons. By using the TMS machine to activate your neurons, it can “massage” parts of your brain that do not function correctly into functioning correctly.
Though there’s no clear trigger when it comes to migraine episodes. Research into brain activity during a migraine points out over-activity in one or more regions of the brain. TMS will stimulate the occipital cortex, which can suppress a migraine by calming brain activity. It may not treat a migraine when it’s already there but could reduce the intensity of the next attacks, or halt it from happening altogether.
TMS therapy for a migraine doesn’t even have to happen in a clinic anymore. Portable versions of the TMS machine is now available, so you can do the therapy in the comforts of your own home. The devices, just like the TMS machine, deliver short but precise bursts of electromagnetism. They are to be placed on the back of your head and used for about 20-30 minutes.
As far as success goes, it was enough for the Food and Drug Association (FDA) to approve TMS as a treatment for a migraine. People who use TMS therapy either found themselves relieved of a migraine for the whole day. The continued use resulted in many patients finding themselves pain-free, even without daily TMS sessions.
TMS technology is moving forward every passing day. First, it was initially used to study the brain and map it out. As our understanding of the brain advanced further, we come up with more ways to use electromagnetism as a way to treat imbalances in our brain. Put it simply, it’s only going to improve as research goes deeper.
To make an appointment with TMS of the Palm Beaches, please contact us at your earliest convenience. We are also here to answer any questions you might have, including about the applicability of your insurance for undergoing TMS treatment.
Humans are the only species on Earth capable of looking into ourselves. Not just in the soul-searching kind of way, but literally opening our heads and studying the brain. Our brain is what makes us tick, what makes us who we are, and nearly all of our body parts are used to either protect or keep our brain running.
Our Brains and Depression
What’s interesting is that our brains are powered by electricity. Our body consumes calories to create energy, which the brain uses to activate its cells and produce the needed signals to keep us alive and make us who we are. Sometimes, the brain fails to function the right way, often caused by infections, abnormalities, or injuries. One such example is depression, a condition where the brain’s altered chemistry causes a person’s thoughts and perception, causing feelings of sadness and disinterest. Sometimes it can be managed using drugs, but medications don’t always work for everyone. Some people are resistant to drugs, others cannot tolerate the drugs itself, and some have persistent or severe depression that won’t fully go away with meds alone.
Through the use of electromagnetism, however, medical researchers and physicians found ways to affect our brain and help treat conditions such as depression. Since several regions of the brain regulate our mood, stimulating these areas could activate neurons in an attempt to awake or realign the circuitry in your brain.
How it Works and What to Expect
Before you start a TMS procedure, you’ll need to do two tests: a physical exam and lab tests to ensure TMS is safe for you. TMS is a safe and harmless procedure, but in the realms of medicine, we always need to be as safe as possible. You could have metal plates in your body from surgery, a pacemaker or similar devices, or foreign objects that could be affected by the magnet.
Then, you’ll undergo a psychiatric evaluation, which is especially important if you are suffering from depression. When all is said and done, you’re ready for TMS therapy.
You’re going to be seated on a chair and the operator will attach sensors to your hand and your head that will monitor your body’s electrical activity. The procedure starts with the physician placing the “coil” over your head activate the machine.
The first step is to activate the coil on certain parts of your brain. When the machine is activated, it will produce a somewhat loud clicking sound and one of your arms or legs may twitch. This procedure is called mapping. Once they are finished with mapping and they have found the area to be stimulated, they will begin the procedure.
The coil will stay on a certain part of your head and the machine will turn the coil on at fixed intervals. The entire procedure may last around 30 to 40 minutes. Afterward, you may feel slight hearing impairment from the loud clicks, and a bit of scalp pain or discomfort. In some cases, you might feel some motion sickness, but all the symptoms will disappear after a few minutes.
The entire therapy may last somewhere between 25 to 40 sessions and is usually done about 5 or 6 days a week.
For more questions about TMS or to schedule a consultation, contact us today.