What is Transcranial Magnetic Stimulation (TMS)?
Repetitive Transcranial Magnetic Stimulation (rTMS) is a recognised treatment for depression and other neurological conditions.
Clinical studies have demonstrated the effectiveness of TMS in the treatment of depression, particularly in patients who have not responded well to anti-depressant medication.
TMS is a non-invasive treatment delivered by an external magnetic coil placed lightly touching the scalp. The coil sends repetitive electromagnetic pulses to stimulate neuron activity in specific surface areas of the brain that regulate mood.
TMS is a recognised treatment for depression by the Royal Australian and New Zealand College of Psychiatrists (RANZCP Position Statement 79 – Repetitive Transcranial Magnetic Stimulation).
What Conditions Does TMS Treat?
The most common condition for TMS treatment is depression.
TMS has also been used to treat:
- obsessive-compulsive disorder (OCD),
- auditory hallucinations,
- post traumatic stress disorder (PTSD),
- attention deficit hyperactivity disorder (ADHD),
- Alzheimer’s disease (AD),
- tinnitus (ringing in the ears).
How Does TMS Work?
Our brains help manage our thoughts via electrical and chemical messengers. Each thought is associated with certain pathways that these signals travel along. The more our brain practices certain pathways the better it gets at whatever we practice.
In depression, the brain has significantly less activity in the frontal lobe and limbic system. We can actually see this in CT scans. In depression you could say the limbic system is way out of practice.
In TMS therapy, a coil is placed over the head and uses an electromagnetic field to induce an action potential in the neurons of the brain, a clinical term which basically means it activates the neuron. An action potential in one neuron causes others around it to fire, and so on.
Repeated stimulation reaches deep areas of our brain using this neuron roadway. Specifically, the limbic system trains the known pathways that are associated with being happier, more relaxed, content and less anxious.
While a single positive thought can train a particular pathway once, a single TMS treatment session can practice that same pathway 3000-5000 times.
A typical course of TMS of 30 sessions can stimulate positive pathways 90,000-150,000 times. It is thought that this practice is what leads to the improvement in mood that we see clinically.
Just imagine practicing kicking a football or practicing a golf swing 150,000 times, you would become very skilled. It is just like this, practice makes perfect. It’s like muscle memory for your brain.
How is TMS Therapy Performed?
To undergo TMS therapy, there is no need for fasting or an anaesthetic. The patient sits comfortably in a reclining armchair and is awake throughout each treatment. The patient’s head is carefully measured by a trained technician to determine the optimal location for treatment.
TMS treatment is non-invasive. The stimulating coil is placed beside the head, lightly touching the scalp. The patient will hear a ticking sound and may feel a mild tapping sensation on the side of their head.
TMS therapy is provided on an outpatient basis or can be part of a treatment plan for hospital in-patients.
How Long Does TMS Take?
TMS therapy is generally administered as a course of 30 treatments over six weeks.
Regular psychometric testing is conducted to monitor your response to treatment. At the end of the course of treatment, a NeuroCentrix psychiatrist will discuss the psychometric test results with you and report to your treating physician.
When patients have achieved significant improvement in their condition, a maintenance course of treatment is often recommended.
Are There Any Side Effects?
TMS is generally well tolerated but may produce some side effects such as:
- tension headache,
- a tingling sensation in the face or discomfort at the application site.
Headache is the most common side effect which responds to over the counter painkillers. Most people find that side effects lessen as treatment progresses.
Unlike some other depression therapies, TMS treatment does not cause memory loss, weight gain or loss of libido.
There is a small risk of seizure. If you suffer from epilepsy or have had a head injury, you may not be suitable for TMS treatment.
To date, there have been no recognised long-term negative effects reported from TMS treatment. However, it should be noted that TMS is a relatively new treatment and research into long-term effects is on going.
Do I Need a Referral?
What Does TMS Cost?
TMS treatment for depression at NeuroCentrix clinics typically consists of 20 to 30 sessions delivered as an outpatient over 3 to 6 weeks. Outpatient treatment allows you to stay at home with family and friends during treatment rather than being admitted to hospital.
Following your initial course of TMS, your doctor may recommend maintenance treatment.
Treatment costs may be met in full for serving military, DVA, and WorkCover patients upon successful application. After referral to NeuroCentrix, we look after the paperwork and prepare the application on your behalf.
Private treatment is available at $185 per session. Medicare does not currently rebate TMS treatment, however some private health funds cover the cost of outpatient TMS.
Speak to our specialist team for more details.
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