Zapping your brain with magnets may sound like something out of science fiction, but it’s actually an innovative medical treatment. It’s called transcranial magnetic stimulation (TMS), and it is already helping people with a number of mental health problems. In his conversation with Julie Korioth, Founder and CEO of Speak as One, RSnake explained that a friend of his, a former Navy SEAL, had tried TMS for post-traumatic stress disorder (PTSD). “They have a lot of interesting experimental science on this,” he said.
What is Transcranial Magnetic Stimulation?
In simple terms, TMS uses magnets to generate electrical currents in specific areas of
the brain. It’s non-invasive. Treatment involves putting a special magnetic coil on the
scalp, and receiving magnetic pulses for up to 40 minutes at a time.
Technically, the term TMS is used when scientists employ a single magnetic pulse (or a
paired pulse) to explore how the brain functions. When repetitive magnetic pulses are
used for therapeutic purposes, it’s called repetitive transcranial magnetic stimulation
(rTMS). But TMS has also come to be used as an umbrella term for all treatments using
magnetic fields in this way.
The idea was first developed in the late 1980s and early 1990s. By 2008, TMS was
approved by the Food and Drug Administration (FDA) for use in major depressive
disorder (MDD). Later, it was approved to help migraine sufferers, then people with
obsessive compulsive disorder (OCD), and smokers.
While it hasn’t yet been FDA approved for any other purpose, various types of TMS have
been researched for treating PTSD, addictions, Alzheimer’s disease, Parkinson’s disease,
schizophrenia, traumatic brain injury, and more.
What Happens in a TMS Session?
Although single TMS sessions don’t take long, they have to be repeated frequently over
time. MDD treatments, for example, are usually provided four to five times per week for
up to six weeks.
Before a session, patients are asked to remove metal jewellery. (People with any metal
implants in the head or brain, or facial tattoos cannot participate in TMS.) On the first
day, a technician measures the patient’s head and conducts some tests with single
pulses to determine how to focus the treatment.
One or more magnetic coils are then placed on the patient’s scalp. Next, magnetic
pulses are administered for up to 40 minutes. People often notice their thumbs
twitching with the stimulation. This is normal.
Patients often wear ear plugs to reduce the clicking noises made by the TMS machine.
People stay awake throughout the treatment and can even drive themselves home
afterwards.
How Does Transcranial Magnetic Stimulation Work?
As anyone who has ever felt the pull of two magnets sticking together knows, magnets
have an invisible force around them. This is also known as the magnetic field. Magnets
and electrical currents both create this field. The earth itself has one.
When a magnet comes close to an electrical conductor, electricity is generated. While
we don’t often see it this way, our brains operate on electricity. Neurons send
information in the brain and through the body using tiny electrical signals. So, when
TMS machines send a magnetic pulse into the brain, electricity is created, stimulating
the brain in that area.
Using a magnetic field is less invasive than inserting an electrode into the brain and
stimulating brain cells that way, which is what scientists were experimenting with (in
mice) before TMS was invented.
Types of TMS
There are a few different types of TMS used for therapeutic purposes. While they all do
essentially the same thing, there are slight differences. These are good terms to know
for anyone interested in exploring TMS.
rTMS
As explained above, rTMS is used therapeutically and delivers short, repeated magnetic
impulses to the brain.
This type of TMS is well-known and can be used for MDD, migraines, OCD, and smoking
cessation.
Theta Burst Stimulation
Theta burst stimulation (TBS) is newer type of therapy. It uses short bursts of magnetic
energy at a higher frequency than rTMS – five times per second. It is called theta burst because it attempts to mimic theta brain waves.
TBS is also used to treat MDD. So far, research shows it’s equally as effective as rTMS
and has the same safety profile.
Deep Transcranial Magnetic Stimulation
Deep transcranial magnetic stimulation (dTMS) uses a different type of coil called an H-
coil. It produces stronger magnetic impulses that can reach farther into the brain and
access different areas.
It is most commonly used to treat OCD, but it has also been FDA approved for MDD.
Safety and Potential Side Effects of Transcranial Magnetic Stimulation
Just how safe is TMS? When used by trained technicians for the FDA-approved uses, it is generally safe. Side effects are usually mild and rare. The most serious problem with TMS has been seizures, but the incidence rate is very low. Only 0.01% of people experience them. Most of the other side effects only last for a few minutes after the session. They include:
- Headaches
- Neck or scalp pain
- Dizziness
- Tingling in the face or scalp
- Temporary ringing in the ears
- High sensitivity to sound
The Takeaway
Transcranial magnetic stimulation is providing hope for many people with severe depression and other types of mental and physical disorders. As the research builds, this treatment will only become more sophisticated, and hopefully will help even more people. For more on RSnake’s experiences with mental health and TMS, tune in to his chat with Julie Korioth.