Transcranial magnetic stimulation (TMS) is a noninvasive procedure to stimulate nerve cells in the brain. The US Food and Drug Administration (FDA) has approved the use of TMS for certain medical conditions, such as migraine with aura, depression, and obsessive compulsive disorder (OCD). There are ongoing studies on using transcranial magnetic stimulation to treat other conditions including stroke, spinal cord injury, spasticity, and psychological disorders like eating disorders and schizophrenia. The principle of the transcranial magnetic stimulation system is stimulation of the brain through a treatment coil. Electromagnetic waves used are similar to those in a magnetic resonance imaging (MRI) machine—a mild electromagnetic current that stimulates the nerve cells without causing any pain and is generally safe. Although the mechanism of how transcranial magnetic stimulation works is still being studied, researches have shown that repetitive magnetic pulses causes changes in the nerve circuits and reduces the function of the hypothalamic-pituitary-adrenocortical system, leading to changes in the neurotransmitters. In stroke patients, when brain cells are destroyed, brain function is compromised. Transcranial magnetic stimulation is used to stimulate the damaged part of the brain to improve function as well as stimulate important hormones, such as growth hormones and brain-derivated neurotopic factor, while reducing signals sent by the normal parts of the brain to the damaged parts. Currently transcranial magnetic stimulation is frequently used to rehabilitate stroke patients who have weakness of the arms and legs, troubled speaking, and difficulty swallowing. It is considered a safe treatment option. It is highly effective when combined with physical therapy.
TMS is typically used when standard treatments such as medications and talk therapy (psychotherapy) don't work. TMS is often used in patients with depression. Despite the fact that it is a treatable condition wiht medications, patients would turn to TMS when standard treatments have not proven effective.
-The specific benefits of transcranial magnetic stimulation for stroke patients vary from the patient to patient and some may respond better than the others. Some may have positive results early while others may respond more slowly or even have no response.
However many studies of different neurological diseases, especially stroke, have shown that transcranial magnetic stimulation treatment is effective in the following ways:
-Increases ability to use the hands, improves grip strength and decreases reaction time in stroke patients with minimal impairment
-Increases efficiency of the nervous system in charge of the muscles on the weakened side of stroke patients with mild impairment
-Increases ability to communicate in patients who have lost the ability to use or understand language (aphasia)
-Improves swallowing ability in stroke patients.(dysphagia)
-Furthermore, many studies on neurological disorders like Parkinson’s have shown that transcranial magnetic stimulation helps reduce abnormal movements, speeding up the movement, decreasing bradykinesia (slow movement), and improves upper body movement, but does not affect overall ability.
-The most common adverse event associated with TMS therapy is scalp pain and discomfort, generally mild to moderate. The incidence of this adverse event declines markedly after the first week of treatment.
-Occasional muscle twitches (during treatment) or headache may occur.
During the procedure a powerful electromagnet is placed over an area of the brain associated with mood regulation. Magnetic pulses are then delivered consecutively to stimulate nerves and depolarize superficial cortical neurons in the brain. TMS treatment requires no surgery or sedation of any kind and patients can resume regular activity immediately after each treatment session.
Your doctor may perform the following test before your procedure: -Physical exam and possibly lab tests or other tests -Psychiatric evaluation to discuss your depression Your doctor will also discuss with you about your health history, and history with having metal implants amongst many other important issues. On the day of your treatment, make sure you bring anything you need to make you feel comfortable during the session. Many patients bring headphones and listen to either music or podcasts during TMS. You may also want to bring a bottle of water and some medicine just in case you get a headache. Finally, make sure to write down any medications you take and their dosages, just in case you need to tell your treatment team.
Side effects are generally mild to moderate and improve shortly after an individual session and decrease over time with additional sessions. They may include: -Headache -Scalp discomfort at the site of stimulation -Tingling, spasms or twitching of facial muscles -Lightheadedness Your doctor can adjust the level of stimulation to reduce symptoms or may recommend that you take an over-the-counter pain medication before the procedure. Serious side effects are rare. They may include: -Seizures -Mania, particularly in people with bipolar disorder -Hearing loss if there is inadequate ear protection during treatment
What is the typical course of TMS Therapy?
TMS therapy is an outpatient treatment that requires a series of treatment sessions. The initial course of treatment typically consists of 5 treatments per week over a 6-9 week period, for an average of 36 total treatments. The actual treatment lasts approximately 40 minutes. During treatment, the patient is awake in a comfortable chair. Maintenance TMS is not well studied; however, it can be provided to prevent recurrence of symptoms with a frequency of 5 daily sessions every 4-6 weeks.
Is TMS therapy uncomfortable?
A little bit, and mostly just in the beginning. The most common side effect of TMS is scalp discomfort during treatment sessions. This side effect is generally mild to moderate, and goes down after the first week of treatment. In studies, less than 5% of patients treated with TMS discontinued treatment due to side effects. Our technicians are highly skilled in reducing any discomfort and can make sure the treatment is easily tolerable for you.
Why should I choose transcranial magnetic stimulation over other forms of treatment?
Patients who are unsatisfied with their current treatments, have experienced unwanted side effects, or who are looking for a non-drug alternative, may find transcranial magnetic stimulation as a viable treatment method. TMS Therapy is an FDA-cleared safe and effective form of depression treatment and used to treat many other mental and neurological conditions.