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The History of TMS

Theory
Getting FDA Approval
TMS Side Effects

More than 100 years in the making, we take a brief glance back at its origin and the concepts behind developing Transcranial Magnetic Stimulation

The idea of using electromagnetic currents to stimulate different body parts particularly the human brain in an attempt to treat various diseases can be traced back more than 100 years ago. It was the time where medical science began exploring the possibilities of electromagnetic efficacy. Unfortunately, technology at that time cannot keep up with the changing times and these studies are not approved by scientific data.

 

Theory Behind TMS

Anthony Barker and his colleagues first introduced the modern Transcranial Magnetic Stimulation (TMS) device what we know today in 1985. However, the physics behind the TMS machine originated from Michael Faraday and Ampere’s law.

Faraday’s theory used 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 uses electromagnetic pulses to stimulate an area of the brain associated with depression. This activates neurons to rewire making emotions and mood behavior more manageable. When these electromagnetic pulses passed through a coil going to the head, the brain will be permeated easily. These activated the neurons directly without any serious adverse effects.

When these electromagnetic pulses intensified or rapidly changed, it generates a depolarizing effect in the brain nerve cells thus releasing neurotransmitters that regulate brain functions.

During the mid-1900’s researchers from the field of Psychiatry began exploring the effect of Repetitive Transcranial Magnetic Stimulation or rTMS in treating depressive disorders. After its initial start, more studies followed suit, focusing on the use of rTMS as a safe and alternative treatment for various mental disorders aside from depression.

Within a decade, around 90 clinical trials and several meta-analyses recommend the use and effects of rTMS in treating major depression.

 

Getting FDA Approval

Following the success of these different clinical trials, and based on the study of O’Reardon et al of using rTMS in the treatment-resistant major depression of 301 patients, the US Food and Drug Administration approved its use. TMS got its FDA approval in treating patients with the major depressive disorder.

The study shows how TMS can significantly improve the overall patient’s mood in comparison to conventional medications. Using TMS as part of depression management treatment proved as a safer and better alternative. Several years later, FDA finally announced in 2008 their approval of using rTMS machine as a major depression treatment.

Having a positive feedback from the FDA proved as a good starting point for rTMS in the management of Treatment-Resistant Depression. TMS efficacy in treating patients suffering from Treatment Resistant Depression is a major breakthrough in medical science. This devastating mental disease incapacitates millions of people, taking away their vitality and enthusiasm to live a normal life. Thus, the discovery of TMS and its usage is a great leap in providing these people another take on life.

 

Another pivotal study

Today, another version of TMS called deep rTMS or dTMS study which targets deeper brain structures had already started.

Launched in 2009, Dr. Xia’s research team at UC Davis started the endeavor of using dTMS for major depression. The study yielded very satisfactory findings. The remission rate of dTMS decreases for people with major depression by almost 50%. Enrolled patients comprised of highly treatment-resistant people who failed on their 2 or more medications in current index depression episode.

 

Great Feedback

Because of its success and significant findings, the FDA approved the clinical use of dTMS immediately. As the study included patients who failed several times in their medication or already acquired intolerance to conventional treatment methods.

Right after this study, TMS became even more popular and widely accepted alternative treatment. More clinics started to accept its concept. Along with this, TMS convinced medical professionals and insurance coverage of its long-term benefits over other medications as well as ECT.

 

TMS Side Effects

Unlike other medications such as antidepressants, TMS does not have any systemic effects including sexual dysfunction, weight gain, nausea, tremors, diarrhea, headaches, constipation, sweating, anxiety, or sleepiness.

TMS does not produce any cognitive impairment as what ECT treatment produces. Patients who received ECT treatment usually suffer from memory impairment due to anesthesia or any muscle relaxant medications.

During TMS session, patients remain fully awake and alert on their environment. As TMS does not produce any major side effects, patients can immediately resume their daily activity. To this date, there are no reports that TMS had produced any long-term or life-threatening side effects.

 

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