Transcranial Magnetic Stimulation Therapy or TMS is a Non-invasive and Non-systemic stimulation of the brain.
The TMS Therapy system generates highly concentrated, magnetic fields which are rapidly switched on and off. These magnetic fields do not directly affect the whole brain; they only reach a few centimeters into the brain, directly beneath the treatment coil.
TMS Therapy is a medical treatment which is delivered by a device that generates changing magnetic fields and it involves placement of a treatment coil over the scalp, passing a rapidly alternating current through the coil wire, which produces a magnetic field that passes unimpeded through the scalp and bone, resulting in electrical stimulation of the cortex. TMS was initially used to investigate nerve conduction; eg, TMS over the motor cortex will produce a contralateral muscular-evoked potential. The motor threshold, which is the minimum intensity of stimulation required to induce a motor response, is empirically determined for each person by localizing the site on the scalp for optimal stimulation of a hand muscle, then gradually increasing the intensity of stimulation.
Most indications require a series of treatments on consecutive days
Transcranial Magnetic Stimulation Therapy (TMS) is a noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain. it does not affect other areas of the body like medications dose.
How It Works
During a TMS session, an electromagnetic coil is placed against specific area on your scalp, based on the condition been treated. The electromagnet painlessly delivers a magnetic pulse that stimulates nerve cells in the region of your brain involved. It's thought to activate regions of the brain that have been affected.
TMS has already received FDA approval for use in adults with treatment-resistant depressive disorders, severe migraines, obsessive-compulsive disorder, and smoke cessation.
Most indications require a series of treatments on consecutive days.
Neuro Behavioral Center utilizes Magventure innovative devices to provide TMS therapy services.
Depression is a hampering disorder affecting nearly 30 % of the US population after COVID 19 (10% prior to COVID) and is generally defined as a persistent feeling of sadness and loss of interest in usual activities.
Depression often affects how you feel, think, and behave and can lead to many emotional and physical problems including poor memory, poor concentration, non-specific numbness, tingling sensations, and more.
Depression Treatment historically involved the following methods:
- medications to simply increase the concentration of the chemical serotonin in the brain and/or;
- psychotherapy and cognitive behavior therapy (CBT).
More recently, TMS has shown high remission and response rate, better than any other treatment methods at times, especially for chronic / resistant depression.
TMS therapy for depression is very robust and is FDA-approved for the treatment of major depression.
Repetitive Transcranial Magnetic Stimulation (rTMS) has revolutionized the treatment of depression and has become one of the most effective and safest ‘natural’, non-medication, remedies for depression. The rate of improvement using TMS treatment for depression has reached 70% in much recent research.
Neuro Behavioral Center is one of the pioneers in providing this advanced therapy. Our highly skilled health professionals are always striving to improve patient health.
Most clinical trials report remission rates of 22% to 40% or lower after acute antidepressant treatment.
Obsessive-compulsive disorder (OCD) consisted of uncontrollable, reoccurring thoughts (obsessions) with or without recurrent behaviors (compulsion). OCD is a chronic disorder that can last long if not treated properly. The sufferer has the urge to repeat certain practices repeatedly.
Obsessive-compulsive disorder affects around 2-3% of the U.S. population. OCD can be debilitating and embarrassing for the sufferer. Fortunately, as for many other conditions, it is treatable. At Neuro Behavioral Center, we have the right treatment options just for you.
Anxiety can lead to symptoms that are often not thought to be related to anxiety at all, including non-specific numbness, tingling, poor concentration, chronic pain, poor memory, and sleep disorders.
Patients with anxiety often do not consciously feel anxious but feel ‘stressed’ or experience poor moods. Also, anxiety levels can range widely from mild, in which there is a degree of worry but no interruptions in bodily functions, life events, work, or personal relationships. More severe cases often cause both physiological and cognitive (mind) disturbances. Bowel and bladder disturbances, IBS (irritable bowel syndrome), and hyperventilation syndrome (breathing faster than average rate) are just a few physiological examples while poor motor and brain performance with daily brain tasks are examples of cognitive manifestations.
Fortunately, several studies have shown a link between TMS and anxiety-symptom improvement. After an examination and consultation with our staff, one of our TMS provider will evaluate if TMS treatment is the right option for your anxiety.
Obesity leads to higher rates of diabetes mellitus, high cholesterol, stroke, heart disease, cancer, metabolic syndrome, and multiple other conditions.
Causes of obesity involve various factors including hereditary predispositions, endocrine (that is, hormonal) abnormalities (for example, thyroid, cortisol, and pituitary abnormalities), poor dietary choices, levels of physical activity and sedentary lifestyle choices. In addition, psychological stress, mood disorders such as depression and anxiety can also lead to irregular and excessive food consumption and habits. The central nervous system has a central role in the pathophysiology of obesity. Central nervous system mechanisms for hunger, satiety, and food craving are now far better understood than even a decade ago. Using neuroimaging and neurophysiological studies, neuroscientists have identified several brain networks that are heavily involved in the control of cravings including that for food. In addition, a clear correlation exists between stress, anxiety, many mood disorders, excessive food intake, and obesity.
Treatment for obesity:
dietary and exercise programs are difficult to maintain when the central brain networks involved in executive function, motivation, emotional regulation are not operating properly. Cases like this leave open the possibility of TMS therapy for weight loss.
By correcting the central (i.e. brain) networks that are involved in regulating behavior, emotions, and ‘executive function’, abnormal food craving is properly mitigated leading to correction of weight and reversal of obesity.
Transcranial magnetic stimulation (TMS) or TMS therapy for weight loss has now a groundbreaking clinical study that shows the use of TMS in lowering food craving and healthy weight loss at approximately 2-3 lbs. per week with only four sessions of TMS.
Currently, several attention deficit treatments are available or in the works for alleviating issues raised by ADHD. Intense research has been conducted that shows that when the brain is stimulated by medication, concentration is given a boost and ADD/ADHD symptoms significantly improve or diminish.
However, some recent studies have shown that using very specific stimulation applied to specific regions of brain, including the pre-frontal cortex, help to reduce ADD/ADHD sy
mptoms without the side-effects associated with long-term use of drugs. Specific neurofeedback strategies have been tested and shown to be a great advantage when managing ADD/ADHD. When non-drug modalities and alternatives treatments are combined, patients have commonly experienced the greatest benefits.
Accelerated TMS denotes a different course of TMS treatment for depression whereas patients receive more than one TMS per day, with some protocols involving up to ten treatment sessions every day. This type of TMS usually shortens the duration of the treatment course from the typical 30 to 36 sessions delivered as one TMS session per day over a period of 7-8 weeks.
One of the most common and recently approved Accelerated TMS is Stanford Accelerated Intelligent Neuromodulation Therapy or SAINT. SAINT protocol involves delivering 10 treatment sessions per day over 5 consecutive days.
Details about SAINT were published online on April 7, 2020, in the American Journal of Psychiatry, a study at Stanford University, entitled Stanford Accelerated Intelligent Neuromodulation Therapy for Treatment-Resistant Depression (SAINT-TRD). A follow-up study published on October 29, 2021, in the American Journal of Psychiatry entitled Stanford Neuromodulation Therapy (SNT): A Double-Blind Randomized Controlled Trial confirmed these results
The only side effects of this new, rapid TMS approach were fatigue and some discomfort during treatment.
Neuro Behavioral Center follows the Stanford study guidelines to perform SNT, patients undergo 10 sessions per day of 10-minute treatments, with 50-minute breaks between treatments, for 5 days.
SAINT summary: Stanford
Official study led to FDA approval
TMS is approved by the FDA to treat major depressive disorder (MDD) and obsessive-compulsive disorder (OCD) and is covered for those conditions by most insurance plans.
TMS is also used successfully as an off-label treatment for:
- Bipolar disorder
- Chronic pain
- Eating disorders
- Multiple sclerosis (MS)
- Stroke rehabilitation
- Substance abuse
In fact, TMS has been used in Europe to treat these and other disorders with great success.
- Medication free
- No systemic side effects
TMS treatment for depression and OCD is covered by most insurance plans, however, the treatment may require prior approval.
There are two main contraindications of TMS treatment:
- having a history of seizures;
- And a ferromagnetic material within 12” of the treatment area that is implanted in the patient’s head such as some metal fragments or electronic chips.
Each treatment session may take between 10 to 30 min based on the condition and the protocol used.
The frequency of treatment sessions may vary based on the condition and the method of treatment, while the treatment for depression consists of daily treatments for 30 to 36 sessions, other conditions might be different. Please discuss the details and the treatment plan with your provider.
The majority of patients can resume their daily activities without any restrictions such as driving and working.
- Remove all piercings from the shoulders up prior to arriving.
- Limit caffeine intake prior to your daily session
- You may take Tylenol or Ibuprofen prior to your treatment session if you are prone to headaches or experienced a headache after your last treatment session
- Arrive a few minutes early to your appointments to check in and complete any required assessments
The TMS technician will
- Ask you a series of questions prior to each session;
- Have you sit in the treatment chair and adjust the chair to ensure maximum comfort;
- Ensure the Treatment coil is properly placed to begin treatment and discuss what to expect during treatment;
- The TMS technician will be in the treatment room with you the entire time
Please contact our office at (508) 660-1666 for precise information regarding costs.
Our treatments are individualized based on the detailed evaluation –we do not offer a “one size fits all package”. As a result, treatment costs vary widely and are uniquely designed to each individual’s needs and case complexity.
It is important to report any of the following prior to each treatment session:
- Seizure activity
- Loss of consciousness
- New head or physical trauma
- Prescribed new medication, especially those that can lower your seizure threshold
- Drug and/or alcohol use
- New health issue or diagnosis, especially involving your heart or brain
The most common side effect associated with TMS therapy is minor headaches and temporary discomfort at or near the treatment site during treatment. This typically occurs only during the first few days of treatment. During treatment, you may feel a light tapping on your head and hear clicking sounds. Side effects are generally mild and improve shortly after.
TMS is an outpatient procedure, in which the patient stays awake the entire time and can be performed in a doctor’s office in less than 30 minutes. ECT is a procedure typically administered in a hospital with the patient sedated under anesthesia and can require an inpatient stay.
TMS, by contrast, can easily fit into a patient’s daily schedule so as not to disrupt one’s routine. A typical session only lasts about 30 minutes, and patients can immediately return to their daily activities following treatment.
Patients who receive ECT have to not only schedule a hospital stay, but they may not be able to return to their normal daily activities for up to two weeks.
Lastly, TMS has fewer side effects than ECT. In addition, TMS does not require sedation, saving a patient the added risk, complications, and side effects associated with general anesthesia, which is necessary for ECT.
You can get TMS, even if you’ve tried ECT in the past. Neither procedure will diminish the effectiveness of the other. Everyone reacts differently to these procedures, so talk to your doctor about which one would benefit you the most.
there are many ways to participate in improving your treatment outcome:
- Do not stop taking your prescribed medication, your TMS provider will review your medications as the treatment progress.
- Limit alcohol and illicit drug consumption.
- Make sure you have good vitamin levels.
- Sleep well.
Depression is a complex condition., there are a number of factors that can contribute to the development of major depression. These include genetic vulnerability, severe life stressors, drug and alcohol use, medical conditions, and other factors. Everyone is different, and depression is usually a combination of factors that alter the way the person’s brain functions.
Because of the various factors that influence each person’s depression, there’s no definitive answer to how long the TMS results will last. Most patients who complete the full course of treatment experience improvement in their symptoms for six months to a year or more. One study to examine 12-month outcomes for patients who completed TMS depression treatment found that after a year, 68% had improved symptoms, and 45% were in complete remission.
You can also see: www.ncbi.nlm.nih.gov
These statistics offer a tremendous amount of hope for people who suffer from depression and have been unable to find relief through medication and psychotherapy alone. In some cases, TMS has proven most effective when used in combination with medication.
Treatments are considered ‘on-label’ when the FDA approves the treatment of a specific diagnosis. ‘Off-label’ indication means that the particular diagnosis in question has not been officially established by the FDA for treatment. However, there are plenty of studies supporting the use of most “off-label” indications. For example, even though aspirin is used ‘off-label’ for the treatment of many disorders such as heart disease, aspirin is not FDA-approved as a treatment for heart disease despite its safety and efficacy.
All TMS treatments follow specific well-studied protocols and have extensive clinical research proving safety and efficacy.