Transcranial magnetic stimulation (TMS) was first developed in 1985 when physicist Anthony Barker introduced TMS technology to the world of neuropsychology.
Based on the premise established over a hundred years prior by Michael Faraday that magnetic fields have an impact on electricity and plasma, TMS technology has been researched for several decades, and has been approved for therapeutic use in the treatment of major depressive disorder and obsessive-compulsive disorder.
Unlike similar treatments, TMS does not require a patient to undergo surgery to attach a device to their body, nor give them instructions to carry around a similar device while it sends pulses to the brain.
TMS is a completely pain free, non-invasive treatment option. The basis for the technology is magnets, but more specifically, it uses the same magnetic energy used in MRI machines to scan the body and find anomalies in soft tissue.
In TMS machines, the same magnetic pulses are concentrated on a specific part of the brain, just a few centimeters under the surface of the skull. Each pulse affects the natural electricity that runs from cell to cell, just as Faraday’s work on electromagnetism revealed.
The result is a subtle change in the way certain neurons work, contributing to an improvement in mood and fewer symptoms of depression and obsession/compulsion, depending on the target of the treatment.
How TMS Works
Transcranial magnetic stimulation isn’t painful, and it doesn’t require medication or sedation. Patients are completely awake and lucid when they receive the treatment, and there’s no injecting or cutting of any kind.
The treatment is applied through a coil built into a special headgear, attached to the machine.
The coil is often what determines how the pulses are sent into the brain, with two main shapes currently in use for therapeutic purposes: an 8-figure coil used in repetitive transcranial magnetic stimulation, and an H-coil used in deep transcranial magnetic stimulation.
Once the headgear is equipped, a patient is asked to relax. The treatment itself takes less than half an hour, but more than one session is required for the changes to fully take effect in a meaningful way.
In fact, sessions need to be scheduled regularly, at a pace of about five sessions a week for 4-6 weeks. Over the course of these sessions, the changes elicited by TMS treatment begin to take shape in the patient, leading to long-term and lasting changes in the form of symptom reduction, and even total remission.
These sessions can be time-consuming when counted together, but each session being less than half an hour long can help make them simpler to schedule.
Researchers are continuing to work on protocols that may shorten that treatment time even further, helping make TMS technology more affordable and more accessible to the general population, and the millions of Americans who may benefit from it.
What to Expect During a TMS Session
Transcranial magnetic stimulation isn’t painful, and it isn’t invasive.
Unlike other forms of neuromodulation which may require surgery or sedation, TMS affects the brain without requiring any form of serious preparation on the patient’s part.
However, it will be felt.
Some have described TMS to feel like a tapping sensation, while others have described it as a consistent and potentially annoying prickling.
One of the more common side effects reported during or after a TMS session is a minor headache. These pass, and are more frequent in the first few sessions, going away over time.
Some report uncomfortable sensations on the scalp, as the magnetic pulses pass through the skull. Again, these are subjective, and complaints tend to decrease as treatment time increases.
For the most part, a TMS session is rather uneventful. The patient can sit back and relax, hold a conversation with the technician at hand, or read something. Patients are asked to refrain from falling asleep, simply so they can be asked how they feel, in case they need to stop treatment.
There are no lasting side effects currently associated with TMS treatment. After a session, a patient is free to leave, and even go back to work/school. Any side effects experienced during treatment are likely to pass within minutes after the session is over.
While a handful of documented cases of seizures after a TMS session exist, these have all occurred due to extraneous circumstances, including an ill-advised mixing of medication prior to the treatment and a previous history of seizures and epileptic episodes. No seizures have occurred as a result of TMS treatment.
Risks and Considerations During TMS Treatment
TMS technology makes use of magnetic pulses to affect neurons in the brain and elicit a positive response, reducing symptoms of depression and other conditions. These magnetic pulses are similar to those used in an MRI machine, and similar precautions must be taken into account.
For example, people with electronic implants in or around the head cannot undergo TMS treatment. This includes pacemakers and other such implants.
Dental fillings and other forms of orthodontics may or may not be safe for TMS, depending on how they were constructed. Consult your dentist and your doctor.
The danger with ferrous objects in TMS treatment is that they may become heated up, distorted, or mobilized as a result of the magnetic pulses used by the machine. As such, it’s also advised to remove any jewelry and piercings before treatment, and one should otherwise speak with their doctor to make sure they’re ready for the treatment.
TMS technology has been around since 1985 but has only been approved by the FDA for the treatment of depression in 2008, and OCD in 2018.
Deep TMS has been approved in Europe for other treatments, and it’s likely that as more research comes to light, TMS applicability will improve as well.