Transcranial Magnetic Stimulation (TMS)

Clinical Services OverviewDiagnostics & TreatmentTranscranial Magnetic Stimulation (TMS)

Transcranial magnetic stimulation (TMS) represents an exciting non-medication and noninvasive option for treatment of some brain health conditions, specifically TMS for depression.

At our center we provide compassionate, comprehensive, and state-of-the art care for patients with depression. TMS works by using magnetic therapy in the form of magnetic field pulses to stimulate the brain’s nerve cells to alleviate the symptoms associated with depression. In addition, there is growing research exploring the effectiveness of TMS in other neurological conditions, including Alzheimer’s disease and other memory disorders.

At Pacific Brain Health Center, Dr. David Merrill offers TMS for depression using a MagVenture device. It offers a unique, short, 3 minute TBS (theta burst) protocol for the treatment of Major Depressive Disorder in adult patients who have failed to receive satisfactory improvements from prior antidepressant medication in the current episode. The team also offers standard TMS for depression.

Scientific background and comparison with existing therapies

TMS has grown out of scientific evidence that mood disorders, such as depression, arise from deficiencies in chemical and electrical function in the brain. These conditions are disorders in the same way that diabetes and hypertension are, and getting the neurological pathways and functions working properly can relieve the symptoms of depression and other conditions. TMS is generally used after other treatment options are no longer helping the patient.

While the exact ways TMS works are still being established, it looks as if the magnetic pulses activate more communication between nerve pathways in the brain and lead to the release of activating chemicals (neurotransmitters) that are important for mood and memory.

Benefits of TMS

There are many benefits to using TMS for depression and other indicated neurological disorders.

  • TMS is a noninvasive, focused treatment option and does not require surgery.
  • Unlike medications, TMS does not have effects on the rest of the body in the way antidepressant medications do, such as causing side effects like weight gain and sexual dysfunction.
  • It does not require anesthesia or cause memory dysfunction the way that electroconvulsive therapy (ECT) does.

The Patient Experience

TMS is almost always an entirely outpatient experience and does not affect the patient’s ability to engage in regular activities. In the initial visit, the patient comes into a doctor office and sits in a comfortable chair. The physician holds or places the TMS coil against the scalp and apply pulses (which patients often describe as feeling like small taps) to the scalp in various places to identify proper location and intensity.

The patient will then return most weekdays for 2-5 weeks for magnetic pulse treatments with a technician. Patients are able to resume normal activities immediately (although it is recommended that individuals have someone drive them home from their first visit to see how they adjust).

Side Effects/Risks

Transcranial magnetic stimulation side effects are minimal and the treatment is usually very well tolerated. There are common, mild side effects, often an achiness in the scalp or face that usually resolves quickly.

There are rare reports of seizures. Therefore, providers conduct detailed conversations with prospective patients regarding any factors that might increase risk of seizures, such as an individual or family history of seizures or use of certain medications.

Before each session, the technician will review safety factors, such as whether an individual is sleep-deprived or has drunk alcohol recently, factors that might require a delay of that day’s treatment. Hearing loss has been reported as a potential side effect but is avoided with use of earplugs.

The situations in which patients cannot receive TMS mostly relate to implanted electrical devices such as pacemakers or aneurysm clips.

More information:
Clinical TMS Society