Transcranical Magnetic Stimulation (TMS) is a non-invasive, physical approach to psychiatric treatment. TMS is based on the principle of electromagnetic induction that allows us to stimulate or inhibit the neuronal activity of specific brain areas. An electrical impulse generates a magnetic field that penetrates through the skull and induces the stimulus in the nervous tissue that modulates the activity of neurons.
The effect can be of two types:
• Activation: induction/increase of the electrical activity of an otherwise inactive or hypoactive area
• Inhibition: reduction of electrical activity in a hyperactive area
Repetitive Transcranial Magnetic Stimulation (rTMS)
Multiple TMS pulses given consecutively are referred to as repetitive or rTMS. Longer repetitive pulse sequences may induce long-term neuroplastic changes, offering enduring alterations that carry therapeutic potential. For this purpose, TMS pulses are usually delivered in trains or in more complex pattern, like Theta Burst Stimulation.
Theta Burst Stimulation
Theta Burst Stimulation (TBS) is a type of stimulation characterized by the rapid repetition of high frequency stimuli (50Hz) divided into triplets of stimuli. Two types of TBS protocols are distinguished:
How Does it Work?
In TMS treatment, an instrument called a stimulator supplies electrical energy to a magnetic coil that generates a magnetic field in the brain for a short period of time. The magnetic field produced by the coil passes unhindered through the scalp to the brain without any dispersion and almost painlessly, thus being able to reach the underlying brain structures, in particular the cerebral cortex, and modify its electrical activity in order to improve symptoms of psychiatric disorders. The coil is placed on the head in such a way as to allow the magnetic field to reach the brain region of interest. The magnetic stimulus produces a recordable response, which is manifested by a noise similar to a series of clicks and a tingling sensation on the skin of the head. The most commonly reported side effect of TMS is a mild and transient muscle-tension headache.
Most people can receive TMS including children from aged 14. Individuals who have had poor response to pharmaceutical treatment and other therapies. However, before having TMS, you need to tell your doctor if you have any metal or implanted medical devices (e.g. aneurysm clips, stents, magnetic fragments), a history of seizures, brain damage or other medical conditions.
The number of sessions will depend on the condition being treated. A minimum number of sessions
for all conditions is 20. This will be discussed with your consultant on assessment and review.
Yes. We have several patients who utilise all of our treatment services to optimise their recovery. We usually run Esketamine and TMS combined treatments for patients suffering from treat resistant depression and have had some fantastic recovery results using this method.
For standard rTMS each session is roughly 17-20 minutes long. For patients who require treatment
on multiple areas, each area will be stimulated for 17-20 minutes. For theta burst treatment (iTBS),
treatment lasts just over 3 minutes for one session, stimulating one area of the brain.
In clinic, we have found 75% of patients get a significant improvement in their symptoms of depression from TMS. It is not possible to know which patients will respond so we break the treatment into two parts. If a patient is not showing any benefit following the first part, during their review with their consultant psychiatrist, we discuss the chances of further improvement with the patient. At this point, we may recommend alternative treatment options rather than continuing TMS
Current statistics suggest that up to 2 in 3 patients will relapse within the first year following their TMS treatment. To counteract this, Optimise Healthcare Group offer various maintenance options to help our patients optimise the improvements they have experienced.
There is no recovery period and patients are able to go about their daily activities immediately following treatment. Some patients report a mild headache following treatment, however, this is generally at the beginning of treatment.
Standard research is based on clients coming to clinic for treatment Monday-Friday and having one
session. However, there are ways by utilising different protocols that these treatment sessions can
be broken up with some patients only attending clinic 2-3 times per week.
Yes, we can provide up to three treatments in a day. Some patients prefer this method as it minimises the number of times they are required to attend clinic in the week.
An ongoing support plan to ensure you maintain the benefits of your treatment can be done and individually tailored for your needs. Cost can be discussed based on the number of sessions.
While both TMS and Electroconvulsive Therapy (ECT) are effective in the treatment of depression, there are many differences in safety and tolerability.
Both are designed to treat depression through the application of energy into the brain, but the similarities end there.
ECT is a more intensive and invasive procedure than TMS: ECT requires an anaesthetic and is designed to cause a controlled seizure. One of the main side effects from ECT is memory loss which does not occur with TMS.
By contrast, TMS is an outpatient procedure with few side-effects. The patient can go about their day-to-day life as normal immediately after leaving the TMS clinic.
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