TMS or transcranial magnetic stimulation is a type of therapy that excites the brain. It is a new, non-invasive treatment that vitalizes nerve cells with electromagnetic pulses. This may improve the symptoms of any mental or neurological disorder. The main use of TMS is for treating depression. Back in 2008, the FDA approved it for…
How Does Transcranial Magnetic Stimulation Treat Depression?
When people with depression fail to respond to conventional treatments like psychotherapy and antidepressants, there is another option called transcranial magnetic stimulation (TMS). Depression remains prevalent in the United States, and the relief that many patients seek from antidepressants does not always come.
Electroconvulsive therapy (ECT), on the other hand, which is common for treatment-resistant depression, can be hard to tolerate because of the side effects on the brain, despite its potency. Continue reading to know how TMS works for treating depression.
Overview of transcranial magnetic stimulation
Simply put, TMS therapy works through non-invasive brain stimulation. Each part of the human brain plays a specific function – for instance, some parts control impulses while some help with memory. With imaging technology, scientists can gain insight into the brain areas that are slightly less active when someone is dealing with depression. The TMS device works as a standalone entity outside the human body. It alters the activity of the central nervous system by delivering strong magnetic fields to certain areas of the brain that are related to depression.
TMS needs no numbing agent or anesthesia and it is generally bearable, compared to the side effects that accompany options like medications and ECT. TMS is not usually recommended for those with a high risk of seizures, like people with a history of head injury, severe neurologic problems, and epilepsy.
The TMS therapy process
TMS therapy is an intense procedure that involves multiple sessions for five days weekly, continuously for several weeks. It takes between 20 to 50 minutes to complete each session, based on the device and technique. Patients will check in with the doctor before the stimulation process starts.
The initial phase is to decide the proper stimulation intensity and the focus area by optimizing the part of the brain called the motor cortex. Focusing on this area of the brain can help the medical team determine the optimal positioning of the stimulation coil in relation to the person’s brain and the intensity required to achieve optimal stimulation.
The doctor will apply the assessment and attempt to locate the dorsolateral prefrontal cortex – the brain area that has been scientifically shown to be involved in depression and with the highest proof of clinical effectiveness. Although patients often experience significant changes in one session, noticeable relief usually comes after three to seven weeks of treatment.
The effectiveness of TMS
Between 50 to 60 percent of patients with treatment-resistant major depressive disorder experience significant improvements with transcranial magnetic stimulation. Up to one-third of these patients get complete remission, meaning their symptoms disappear. As will many treatments for mood disorders, the recurrence rate is high.
However, most patients who undergo TMS continue to be asymptomatic for several months after ending treatment, with the average length being somewhere over 12 months. The depressive symptoms disappear permanently in some cases. Patients can return for another round of TMS therapy if required. For optimal outcomes, medical professionals usually recommend therapy after treatment to learn effective coping mechanisms following treatment.
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