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Transcranial Magnetic Stimulation

TMS or Transcranial Magnetic Stimulation is a new treatment for depression that uses pulsating magnates to stimulate parts of the brain believed to be responsible for depression. The activation of the brain cells requires the repetition of this magnetic pulse. Hence it is sometimes called repetitive Transcranial Magnetic Stimulation or rTMS. Transcranial Magnetic Stimulation is a non-invasive outpatient treatment for depression. In TMS we use a magnetic pulse to stimulate areas of the brain connected to depression circuits.

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TMS targets the under or over-functioning area of the brain with a magnetic pulse or electric currents to realign and stimulate the correct signals thereby reducing or eliminating depression or symptoms of PTSD. An electromagnetic coil also is known as a TMS coil is placed on your scalp and delivers a non-invasive, pain-free pulse directly to the specific area of the brain known as the  DLPFC or the dorsolateral prefrontal cortex affected by a particular condition. It also increases the production of serotonin which is essential to brain cell repair and is a core ingredient in antidepressants.

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TMS is one of the safest treatments currently available for depression aside from talk therapy. TMS therapy has proven safety and efficacy in many clinical trials.​

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The most common side effect of TMS therapy is scalp irritation or discomfort. It is reported in about 5% of patients and it usually goes away after a few sessions.

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What is TMS

How does TMS therapy works. In rTMS, the magnetic pulses are delivered at a frequency of 10 Hz, meaning that 10 pulses per second. Each train of pulses is delivered for 4 seconds. This means each train of pulses is 40 pulses. A break between the trains of pulses is between 11 to 26 seconds. Then a new train of pulses comes along for another 10Hz X 4 Seconds = 40 pulses. This is repeated for 75 trains. By doing the simple math, we can find out that we deliver 10 (Hz) X 4 (Sec) X 75 (Trains) = 3000 pulses. So technically, the patient is receiving 3000 pulses of stimulation each session. This particular stimulation of the brain cells will activate this area of the brain in the frontal lobe, which is connected to the limbic system.

Theta-burst stimulation or iTMS is a form of transcranial magnetic stimulation that uses theta frequency to stimulate the brain. Using the same frequency that the brain uses to communicate with its internal circuits, we might be more effective and time-efficient. With theta-burst stimulation, we deliver a triplet of pulses at a frequency of 50 hertz for 200 milliseconds intervals for a train duration of 2 seconds which means a total of 10 triples of pulses in 2 seconds. This is a total of 30 pulses. Because those 10 bursts of pulses are delivered in 2 seconds trains, this gives it a frequency of 5 Hz, which is in the range of what we called above theta wave frequency, the frequency used by the hippocampus to communicate with other circuits of the brain. Because this is more effective in stimulating the brain, we don't need to do it for 75 trains, and we could just get away with 20 trains. Also, the interval between the trains is only 8 seconds, saving even more time. Doing the math here, it means that you were giving 3 (triplet pulse) X 5 (Hz) X 2 (Sec) X 20 (trains) = 600 pulses.

TMS therapy is indicated for the treatment of Major Depressive Disorder in adult patients who have failed to receive satisfactory improvement from prior antidepressant medication in the current episode. Also, TMS therapy is FDA-cleared for the treatment of OCD in adult patients who have failed to receive satisfactory improvement from prior treatments. Also recently dTMS therapy got FDA-cleared for smoking cessation therapy. TMS is used off label for many other psychiatric disorders like anxiety and PTSD.

Common Side effects

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

  • Lightheadedness

 Insurances accepted 

Aetna, Aetna Medicare MA plan, Medicare, Optum, Oscar Circle Plus, Oscar Health Plan, Oscar Small Group Plan, UBH General

Email Us: info@healmed.org

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Call Us: 732-508-2136

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