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Studies Concerning Transcranial Magnetic Stimulation

How TMS Started
Electromagnetic Treatment
Safer Treatments

Over the past few years, there are several studies indicating the efficacy of Transcranial Magnetic Stimulation or TMS as an alternative depression treatment.

Researchers at Butler Hospital along with the collaboration of different clinics in the US confirmed the efficacy of TMS treatment for patients with depression who were unsuccessful on their antidepressant medications. Their finding is one of many first studies who delved into the use of TMS treatment. It was published on June 11, 2012 edition of Depression and Anxiety in the Wiley Online Library.

 

How did TMS Start?

Anthony Baker introduced TMS in 1985 at the University of Sheffield in England. It was intended as a neurodiagnostic tool used to produce an evoked potential in muscle tissue by activating neurons in the motor cortex. The whole concept of TMS was based on the two basic principles of physics; Faraday’s principle of electromagnetic induction and Ampere’s law.

Faraday’s principle involves the use of electromagnetic induction and that voltage can be measured and changed when generated across a length of wire – if the wire was left exposed to a perpendicular magnetic field flux of alternating intensity. Also, Ampere’s law state that the magnetic field can be managed around an electric current is proportional to the electric current.

TMS principle revolves around this principle. The stimulation coil consists of several wire loops encased in an insulating material. According to Kobayashi M, Pascual-Leone A. in Transcranial magnetic stimulation in neurology, “If a pulse of current is passed through this coil and placed over a person’s head, it produces rapidly changing magnetic pulses that penetrate the scalp and skull and reach the brain with minimal attenuation.”

Because of this, TMS can emit rapid and powerful but painless magnetic field that stimulates brain nerve cells. In doing so, it activates inactive region in the brain associated with depression.

Since its introduction in 1985, TMS had been studied as an alternative treatment for various mental disorders. Several studies show that TMS can be an effective treatment for major depression, Tourette syndrome, reducing auditory hallucinations in patients with schizophrenia, and obsessive-compulsive disorder. There a lot of evidence showing the efficacy of TMS in psychiatry.

 

Another Form of Electromagnetic Treatment

However, TMS was not the first treatment introduced that uses electromagnetic pulses. It was Electroconvulsive therapy (ECT) that was first used in 1938 which also show the significant result in treating major depression. Unfortunately, ECT uses an invasive method like anesthesia which resulted in severe side effects. It soon loses its popularity amongst patients with depressive disorders.

ECT remains one of the most controversial forms of treatment in the entire field medical science. It’s a love and hate relationships. But one film stands out in providing a wide range of people about the use ECT. The film “One Flew over Cuckoo’s Nest”, shows how crude treatment method ECT can get. Even though ECT can also effectively treat depressive symptoms, there has been a steady decline of its use in clinical psychiatry clinics.

 

A Safer Treatment Method

About 16.1 million people suffer from depressive disorders across the US. Depression is a serious illness affecting 350 million people worldwide; it’s becoming the largest health problem in the world. The medical community had developed medications and treatment plan to help manage its symptoms but there are patients who do not respond positively to these. Using medications often entails adverse side effects like tolerance and drug addiction.

The approval of FDA for TMS had cleared the TMS brain-stimulating device for treating depressive disorder to patients where antidepressant has failed to work. TMS brings new hope and vitality to patients and their families wherein it shows better results than the conventional treatment plan. It has far lesser and fewer side effects, some does not even experience and adverse reaction to TMS procedure.

TMS procedure shows its efficacy to over 24,000 people suffering from depressive disorder. About 1 out of 3 people have experienced complete remission from depression. While 50% of patients reported having significant reductions in their symptoms. The American Psychiatric Association also supports the use of TMS for patients who develop tolerance over their antidepressant medications. They suggest that medical professionals should consider TMS as a form of treatment rather than changing from one antidepressant to the other. Using antidepressant medications often lead to drug addiction.

One study conducted by Garcia-Toro M, Mayol A, Arnillas H, et al in their book entitled “Modest adjunctive benefit with transcranial magnetic stimulation in medication-resistant depression” shows that TMS can treat depression symptoms as effectively as any antidepressant medications.

 

Obsession & Compulsions
Available OCD Treatments
Alternative Treatments
Side Effects of TMS

 

What is OCD?

Medical professional describe Obsessive Compulsive Disorder (OCD) as a mental health problem that affects people of all ages. It often occurs when a person gets stuck between a cycle of obsession and compulsion behavior.

Obsessions are characterized by unwanted and intrusive thoughts or urge following severe and distressing feelings. Meanwhile, the behavior is often followed by compulsions in which a person engages in behaviors to alleviate to decrease the feelings of distress.

Most people experience obsessive thoughts and/or compulsive behaviors at some point during their lifetime. However, it does not mean it’s a part of an OCD problem. In order to have OCD, the cycle of obsession and compulsions becomes so extreme that it interferes with the normal daily activity. The obsessive and compulsive behaviors consume a lot of time that it left the person almost immobilize.  

 

What are Obsessions and Compulsions?

Medical experts characterize obsessions as thoughts, impulses and even images that occur repeatedly outside the person’s control. People suffering from OCD consider these thoughts as disturbing and in most cases, these thoughts do not have valid reasons. Usually accompanied by uncomfortable and intense feelings, people with these obsessions feel those things ‘have to be done in a very particular way.’ For people suffering from OCD, these obsessions are time-consuming and take most of their time away from other important activities in their lives.

 

Available Treatments for OCD

Conventional treatment for OCD typically comprises medications and psychotherapy. Unfortunately, prolonged ingestions of prescription drugs often lead to drug tolerance or worse drug addictions. With the discovery of Transcranial Magnetic Stimulation technique efficacy for depression, it offers a safe alternative treatment for other mental disorder.

 

An Alternative Treatment for OCD

TMS is a non-invasive method of producing great results which are very well tolerated by many patients. First developed during the mid-1980s, TMS has become the focus of many neuroscience studies and clinical applications.  The Food and Drug Administration first approved the use of TMS for treating depression in 2008. Several years after FDA also approved the use of ‘deep TMS’ for depression and two additional devices. Many of these studies show positive results and scientists are now delving into the possibility that TMS can also be an effective treatment for patients with OCD.  

TMS is a simple procedure that involves placing a small device directly on top of the head. Medical professional targets the prefrontal cortex of the brain which often associated with mood regulation. TMS machine produces electromagnetic pulses that passed through the scalp targeting certain areas in the brain. It stimulates the inactive brain areas while suppressing the overactive region which results to better mood and behavior.

The flow of the electromagnetic pulses through the device stimulated neurons in the brain-altering its activity levels.  Scientists linked these neurons activity to mental disorders including OCD. There are several indications that repetitive TMS or rTMS can improve the psychological well-being of patients with OCD as the procedure can lessen depressive symptoms that often go along with OCD.

 

Deep Transcranial Magnetic Stimulation

Scientists are also looking in the efficacy of deep TMS as another method of treating OCD. Deep TMS uses an H-coil which creates magnetic field penetrating more deeply into the brain. As it can affect greater brain region and stimulates more brain neurons, it shows a lot of great potential in treating mental disorders like OCD.

The FDA both approved the use of rTMS and dTMS for treating major depressive disorders. More studies are being conducted to prove its efficacy for OCD and other mental illnesses. Getting these procedures requires proper and thorough medical assessment from medical health professionals. Depending on the severity of the disorder, they can recommend the best possible method for the patient. Either way, both TMS technique offers safe, reliable, and effective treatment for OCD without severe adverse effects often associated with prescription medications.

 

TMS Side Effects

There are no known severe adverse effects of TMS. Medical health professionals consider the method as safe when used in accordance with its established guidelines. TMS machines emit electromagnetic pulses like those in MRI, and there are certain limitations for using the device. People with implanted metallic objects, like pacemakers, bullet fragments near the head, deep brain stimulators, aneurysms coils, facial tattoos, and other objects implanted near the head are prohibited using TMS.

TMS is typically done inside the doctor’s office as an outpatient procedure. Patients can immediately resume their daily activity right after undergoing TMS. They may feel a slight tingling in the head, sleepiness, and headaches which usually improved after each treatment session.  Doctors usually advise patients to undergo series of treatment sessions. Treatment sessions vary from one patient to another, but usually, have 5 sessions a week within the duration of 4 to 6 weeks.

 

TMS Safety
Alternative to Medications
Drugs and Their Side Effects
Side Effects of TMS

Clinical depression remains the topmost health problem in the US and affects more than 40 million adults each year. Major Depressive Disorder is the leading cause of disability and is more prevalent in women than in men. Around 75% of people suffering from mental disorders remain untreated in developing countries. It’s a growing mental illness worldwide as pharmaceutical companies race to develop new drugs for the treatment of common depressive disorders. The medical community continues to search for new and safer alternative therapies, which eventually led to Transcranial Magnetic Stimulation.

Transcranial Magnetic Stimulation was first developed in 1985, and was considered safe for treating various disorders. It received a monumental step by getting the US Food and Drug Administration approval in 2008 as an alternative treatment for Major Depressive Disorder. As a non-invasive and non-systemic procedure with minimal side effects, health care providers consider TMS as a safe and effective treatment for depression.

 

TMS is Safe and Easy

Compare to conventional depression treatment which requires taking prescription drugs, TMS therapy has not been associated with undesirable side effects like addiction. Patients will not experience excruciating side effects like sleep problems, digestive problems, anxiety, and sexual dysfunction. Most patients can only feel mild to moderate temporary discomfort at the site of the coil following the first round of treatment.

Doctors and experts can confirm that TMS therapy is a safe and effective alternative treatment for Major Depressive Disorders. And because of it’s continued success, there a number of on-going studies experimenting with TMS as another form of treatment for various diseases.

It’s a proven safe technique for all patients; TMS is gaining popularity across the globe. As an FDA-cleared method, TMS consistently show its efficacy in treating other health problems like PTSD, stroke, anxiety, autism spectrum disorder, eating disorder, even as pain management.

 

A Good Alternative to Prescription Medications

TMS is a non-invasive and non-systemic technique that has lasting positive effects. Even with patients who failed to respond to previous prescription medications and psychotherapies. This relatively new technique targets the brain area associated with depression. It regulates brain chemistry thus promoting a well and balance activity in the brain.

It uses electromagnetic pulses similar to MRI and precisely targets the prefrontal cortex of the brain. This helps to regulate the mind’s unique electrical activity. TMS can activate inactive brain cells while suppressing overactive regions without the use of any antidepressant drugs.

 

Prescription Drugs’ Adverse Side Effects

Using prescription drugs and antidepressants may work for about a fraction of people suffering from Major Depressive Disorders. Sadly, the majority of the patients do not respond to these medications and its long-term effectiveness, side effects, and costs are some of the downfalls of antidepressants.  But the biggest concerns in taking prescription drugs are the debilitating consequences. Experts estimate about 70% of people who tried alternative therapies like TMS have a better chance of recovery and beating depression, in the long run, compared to taking medications.

TMS directly stimulates brain neurons and in building new neurotransmitters to release ‘happy hormones’ within the brain structure. The technique jump starts the brain in having the natural action of regulating its structure and chemistry. Even without any prescription drugs and medications involved, it does not illicit major side effects of addiction and drug overdose. Patients can undergo TMS therapy without the fear of having to take medications or undergo major surgeries.

Health care providers use TMS therapy as a long-term preventive measure for depression relapse, one of its biggest advantages. TMS therapy stimulates the brain in keeping those newly formed neural pathways linked together for the life of the patient.

 

TMS Side Effects

There are certain side effects that patient may experience during TMS procedure, but these are just minor health concerns. Since the TMS machine function like an MRI, some of its side effects are related to later like headaches and dizziness. Some may experience slight tingling sensation at the site but will eventually subside following the therapy.

However, patients with metallic implants, cochlear implants, pacemakers, bullet fragments, and the likes are prohibited from using TMS therapy. Patients kept fully awake during each session which may last for about 40 minutes in five times a week over the course of four to six weeks of treatment. Since it’s done inside a doctor’s office without any anesthesia or surgery involved, patients can immediately go back to their daily tasks following the treatment.

 

How was TMS First Done?
Brain Stimulation Research
Uses of TMS

The first known brain stimulation attempts using electromagnetic stimulation goes as early as 1896 when Jacques-Arsene d”Arsonval of Paris and Silvanus P. Thompson showed the first ever prototype in London. However, it was not until 1985 when Anthony Barker and his team showed the first successful demonstration of Transcranial Magnetic Stimulation at the Royal Hallamshire Hospital in Sheffield, England.

 

How Was it Done?

Barker and his team essentially took a leaf out of Michael Faraday’s book. They made a single Faraday coil and place it above the left prefrontal cortex using a motor strip and saw the right hand moved. Barker’s team first did the experiment on themselves. This single yet monumental experiment created ripples within the medical community. The result created excitement and interest in the international research community about using TMS for various medical usages. Because of such feat producing concrete proof that electromagnetic stimulation of the brain showed a direct tissue response, the medical community credited Anthony Barker as the inventor of TMS.

 

Brain Stimulation Research Studies

Since its discovery, there was an exponential growth of different international studies on brain stimulation. Majority of these studies focuses on the use of TMS in treating different mental disorders, side effects, and most importantly – its efficacy. Today the field has garnered enough topics to have its own called Brain Stimulation.

 

TMS Uses

Health Canada was the first government body to approve the use of TMS in 1997. Soon after, it got its first official use in treating resistant depression in 2002. The US Food and Drug Administration approved TMS therapy in 2008 after taking into consideration its risk and efficacy.  

Today, TMS machine uses electromagnetic wave pulses similar to an MRI machine; it’s generally safe for everyone. Medical providers placed the coil near the prefrontal cortex of the brain associated with depression symptoms. The electromagnetic waves suppress overacting brain regions while activating inactive brain cells. This creates a new chemical balance within the brain structures thus relieving the patients with the depressive symptoms. It’s a simple procedure that does not require any hospitalization, anesthesia, or surgeries. Patients undergoing TMS therapy are kept fully awake and can immediately resume their daily routine following the session.

Some studies even show that lasting effect of TMS without relapse and even without taking antidepressant medications. Numerous research studies have been published since its approval and TMS therapy consistently show great promise of treating resistant major depressive disorder and other mental health diseases.

Just recently, the 2nd International Conference on Brain Stimulation Conference in Barcelona, Spain held on March 6, 2017, awarded Anthony Barker, Ph.D. the International Brain Stimulation award. About a thousand or more people from across the globe attended the conference with professionals from a myriad of disciplines such as neurosurgeons, neurologists, biomedical engineers, psychiatrists, and researchers.

The conference was a great platform for speakers from the international community to present their data and research about the different types of brain stimulation topics. For several days, topics like TMS, deep TMS, ECT, vagus nerve stimulation, effects of ultrasound on brain tissue, and other invasive brain stimulation were presented to the public.

But the highlights of the studies include topics of the potential uses and indications for TMS therapy. Some experts showed different types of research about the future use of TMS for treating addictions such as cocaine, opiates, alcohol, nicotine and even obsessive-compulsive disorder. There was even a research that shows great promise for the potential benefits of TMS in treating pain sufferers and for stroke rehabilitation.

With its success of treating major depressive disorders with no or minimal side effects, TMS therapy is the focus of widespread research studies. TMS providers continue to seek and explore its uses in treating various disorders.

 

What are Eating Disorders?
Types of Eating Disorders
Factors
Conventional Treatment
TMS to Treat Eating Disorders

 

Eating habits are vital to having a healthy body and mind but some people have difficulty maintaining a good balance of proper eating habits. Many suffer from eating disorders as a part of stages or routines in their daily lives but cannot be classified as a serious illness.

It can influence one’s entire social life and even affect them mentally, with an addition of physical weakness which puts lives in danger. Several types of research show that it can be treated as a Diagnostic and Statistical Manual of Mental Disorders (DSM) textbook mental disorder. An estimated 20 million women and 10 million men in the USA are recorded to have an eating disorder.

 

What Are Eating Disorders

Eating disorders can be classified as abnormal eating habits resulting in a condition of disorders that greatly affects the person’s normal lifestyle. An eating disorder like overeating may lead to body weakness and even death.

It can be manifested in different signs and symptoms, some in over-restriction of food or pursuit of inappropriate food, or behaviors such as vomiting and overactivity. Everyone is vulnerable; it affects all ages and gender but mostly in the age of adolescence, especially in young women. Many who reported were as young as 13 years old, a whole 13 percent of the total youth population.

 

Different types of eating disorder

The most common and popular type of eating disorder, Anorexia Nervosa affects mostly young adolescence and it greatly affects more women than men. People suffering from anorexia nervosa tend to either overweight or critically underweight. Some noticeable behaviors include constantly monitoring their weight, severely restricting their calorie intake, or avoiding certain food groups.

Bulimia Nervosa

Bulimia nervosa is another well-known eating disorder. Like anorexia, it develops during adolescence period up to early adulthood.  It is developed during adolescence age and its population is not merely women. It can have a manifestation of a large amount of food intake in a short period of time. A person who suffers from the disorder has no control over their eating habit and does not stop until they are satisfied fully.

 

Binge Eating Disorder

Over the past few years, binge eating increasingly grows to become one of the most common eating disorder in the US. People suffering from binge eating disorder have similar symptoms that of bulimia or anorexia. They usually eat large amounts of food in a relatively short period of time and typically lost self-control during binges.

People suffering from binge eating disorder do no restrict their calories intake or have any purging behaviors like to the two previous disorders.

 

Pica

The medical community recently recognized Pica as an eating disorder which involves uncontrollable ingestion of dirt, soil, chalk, hair, paper cloth, pebbles and even laundry detergents. Pica occurs in an adult, particularly in adolescents. Pica is most commonly observed in pregnant women and people with mental disabilities. Unlike other eating disorders, people with Pica conditions are prone to high risk of poisoning, infections and nutritional deficiencies leading to fatal health conditions.

 

Avoidant Restrictive Food Intake Disorder

It occurs in infancy or in early childhood days especially the younger one under 7 years old below. It manifestation include loss the interest in eating or unable to taste different kinds of food in way of smell, and in other important things in a sense regarding in food influence. Avoidant or restrictive food in the taking disorder (ARFID) was the previous name for this old disorder.

 

Factors that trigger eating disorders

There are no exact causes of anorexia but there are various factors to consider in the development of disorders such as the following;

  •    Mental factor – the emotional situation can cause of this like depression that affect mental ability.
  •    Environmental factor – family background may pose a risk of developing eating disorders if a family member already acquired an eating disorder.
  •    Hereditary factor – certain genes or hormones carry a hereditary factor that might trigger an eating disorder.  

 

Conventional Treatments

All eating disorders should be treated as early as possible. This is to lessen the number of different physical health risks for people suffering from eating disorders. Also, early intervention showed better outcomes of recovery.

Common eating disorder treatments include antidepressant medications and cognitive behavior therapy. However, it is still difficult to treat eating disorders with no definite guarantee of success.

 

TMS poses a new way of treating eating disorders

An estimated 8 million Americans suffer from chronic eating disorders like bulimia and anorexia. Medical professionals commonly treat eating disorders with prescription drugs and behavioral therapy, but it does not help everyone.

New research shows that Repetitive Transcranial Magnetic Stimulation or rTMS poses a possible significant medical breakthrough in treating people suffering from eating disorders. In a case study done in 2011, a patient who was diagnosed with both bulimia and depression underwent rTMS for 2 weeks and had an almost complete recovery from both conditions.

Scientists believe that eating disorders are a characteristic derived from the brain circuits associated with the dorsolateral prefrontal cortex in the brain. rTMS is known to stimulate an inactive region of the brain while suppressing the hyperactive part. Another study shows that patients with eating disorders symptoms received significant recovery after 6 months of rTMS treatment. Using rTMS as an alternative treatment for eating disorders can normalize brain activity associated with mood regulations.

 

Alternative Depression Treatment
Highly Effective
How TMS Works 
No Substantial Side Effects

Many experts now consider depression as a major health issue. It affects more than 14 million American adults every year. Medical experts believed that it will be the second leading cause of disability in the world by 2020. About two-thirds who suffered an episode will at least have another episode during their lifetime. Depression is an incapacitating illness and treatments methods are often ineffective or intolerable because of its adverse side effects.

Current antidepressant medications and therapies failed to at least a third of people suffering from depressive disorders leaving them with inadequate treatment options.

 

TMS as an Alternative Depression Treatment

TMS therapy is a relatively new non-invasive procedure that delivers highly focused magnetic pulses to a specific brain region called the left prefrontal cortex. It stimulates the inactive areas of the brain associated with depression. These electromagnetic pulses are similar to the magnetic field of an MRI procedure. The rapid bursts of magnetic energy passed through a coil and directly to the brain excite neurons which rewire the brain to improve mood behaviors.

As a non-invasive procedure, TMS does not involve any major surgeries, insertion of intravenous lines or any kind of medications that may harm the body. There is no sedation or anesthesia involved during TMS session treatment.

 

An Effective Treatment

Over recent years, experts have discovered newer treatment parameters and more precise targeting locations for TMS. Several studies show that TMS can be an effective treatment not only during the course of 4 to 8 weeks sessions but also having these improvements persist beyond that time.

 

How TMS Works

TMS uses a computer program connected to a small electromagnetic coil which delivers short but rapid bursts of magnetic pulses directly on the left prefrontal cortex of the brain. However powerful these electromagnetic pulses, it does not affect the entire brain. The electromagnetic pulses of TMS can reach about 2 to 3 centimeters into the brain right underneath the treatment coil.

This treatment coil is placed on top of the patient’s head that believed to be linked with mood regulation.

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As electromagnetic pulses reach deeper into the brain, they produce tiny small electrical currents. These electromagnetic currents activate neuron within the brain which believed to release important neurotransmitters.

 

In October 2008, the US Food and Drug Administration approved the use of TMS treatment for the major depressive disorder. This revolutionary treatment option received approval for its safe and effective therapy, particularly for treatment-resistant patients.

 

One of the studies about TMS shows that the procedure was a significant alternative method to preclude impending relapse in 32 of 38 patients or about 84%. This strongly suggests that the efficacy of TMS is seen in the majority of acute treatment-resistant patients. The reintroduction of TMS later in the medical management of depression can safely and effectively prevent relapse.

 

No Major Side Effects

TMS does not have any major side effects unlike its counterparts of conventional depression treatments. This new innovation does not produce common side effects like memory loss, sleepiness, sexual problems, or weight gain. It serves as an ideal major depression treatment because it does not elicit side effects of conventional medications like drug abuse.

As a non-systemic procedure, it does not require any sedation or implantation of other depression treatments like those of deep brain stimulation.

Today, TMS is widely acclaimed for its treatment of major depressive disorder but other studies are underway to prove its efficacy to other mental disorders. Different types of research are being conducted each year to explore possibilities of TMS as a treatment for a wide range of different brain disorders like Generalized Anxiety, Obsessive Compulsive Disorder, Cognitive Impairments, and Tinnitus.

 

What is TMS?
How does it work?
What to expect with TMS
Safety precautions
After treatment 

 

What is TMS?

Transcranial magnetic stimulation or TMS is a non-invasive medical treatment that uses a magnetic field to stimulate nerve cells in the brain mainly for depression. However, recent studies show that TMS can cure a variety of mental disorders including addiction.

 

How does it work?

In this procedure, the electromagnetic coil is placed on the scalp of the patient near the forehead. The electromagnet delivers a magnetic pulse to stimulate nerve cells in the brain that involves regularization of the mood control and depression. TMS activates this region of the brain to reduce the activity associated with depression. It sends stimulation effects in the part of the brain linked with treating depression and mood improvement.

Treatment of depression is through repetitive magnetic pulse called r TMS or TMS. Depression is well treatable but a lot of people failed to achieve success using conventional medical treatments and therapies. TMS, on the other hand, is an effective alternative treatment for depression with fewer or no relapse at all.  Unlike the other procedures including nerve stimulation or deep brain stimulation, TMS is a non-invasive and non-systemic treatment. As a non-systemic procedure, it does not cause any side effects of seizures or any sedation with anesthesia.

Patients with melancholic depression can also benefit from TMS.  There are several studies suggesting on how to use TMS on specific disorders.  Multicenter studies on efficacy for 6 weeks will test whether a longer period of stimulation is more effective in a controlled setting. While another research shows that a right-sided stimulation is more effective.

 

What to expect in a TMS session?

This medical procedure uses an electromagnetic coil extends with a high-intensity current that turned on and off in the coil through the discharge of a capacitor. This is a time-varying a magnetic field which lasts for about 100 – 200 microseconds. The strength is about 1.5 to 2 Tesla at the surface of the coil.

Healthcare professional conducts TMS as an outpatient basis in a clinic and it requires a series of treatment sessions to become more effective and preferably within five times a week for about four to six weeks. The attending doctor will conduct the procedure in the best place. Pacing the magnet on the head and best dose of magnetic energy will be given. Upon the first session of appointment, the patient will be placed in a treatment area where there is a wearing of earplugs, an electronic coil will also be placed in the forehead and switches off and repeated to produce stimulating pulses.

The tapping of the sounds will last in a few seconds and then pause for a while, the feeling sensation on the forehead called mapping. Doctors will then determine the right amount of magnetic energy that patients needed.  

During the actual treatment, once a coil is placed on the forehead and dose is identified, now ready to start the procedure. Once settled in a comfortable chair wearing earplugs and the magnetic coil placed, health care professionals will turn the machine on. The patients will then hear a clicking sound or feel a light tapping on their forehead. The procedure will last about 40 minutes, patients will remain wide awake and alert the entire session. Patients may feel some mild discomfort during the treatment within the first week but will ultimately subside afterward.

 

Safety Precautions

The preparation of TMS should always be observed before applying to patients. TMS treatment is not for everyone, although relatively safe, there are pre-medical evaluation and tests. These include the following:

 

  • Physical examination and doing laboratory tests or any other tests required to make sure that the r TMS is safe and in normal,
  • have a psychiatric assessment to evaluate the mood of depression,
  • any metal or implanted medical device in the body in some patients or people with metal implant device can have the procedure and due to strong magnetic field

 

Furthermore, it is recommended for the following persons who have aneurysm clip or coil, stents, implanted stimulators, implanted vagus nerve or deep brain stimulators, electrodes for brain monitoring, implanted electrode device such as a pacemaker, medication pump, and bullet fragments to undergo TMS. 

 

After TMS treatment

After treatment, normal activities or daily works are normal once the patient was treated, such as driving and working in the offices and others. May different ways to perform its techniques may vary according to the studies for more effectiveness.

 

TMS effectiveness in depressed patients takes about several weeks of treatment depending upon the cooperation of each patient. Symptoms will drastically improve during and even after treatments. There are no significant signs of relapse. When undergoing the procedure, it involves continuing treatment until patients are symptom-free with the hope that will prevent relapses.

 

Depression improves clinically proven with TMS and if there is an episode or return of symptom it can be repeated again called re-induction. All the procedures and management will become helpful for the intervention to prevent and detect the depression or any other mood disorders.

 

Theory Research
Repeating Pulses
Digging Deeper

 

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.

 

What  is TMS?
Benefits of TMS 
Additional TMS Benefits 

 

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.

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TMS of the Palm Beaches

4205 W. Atlantic Avenue, Ste. C301,
Delray Beach, FL 33445

Phone:
(561) 332-3285

Fax:
(561) 332-3279

Serving:

Palm Beach, FL
Palm Beach County
Broward County
St. Lucie County
Martin County
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