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What is Transcranial Magnetic Stimulation?

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.

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