13 Apr Brain Health and Transcranial Magnetic Stimulation
What is Transcranial Magnetic Stimulation?
Transcranial Magnetic Stimulation (TMS), as its name implies, is the therapeutic application of magnetic energy pulses to the brain. These pulses travel through the skull and stimulate the cells of the brain, called neurons. Advocates for TMS theorize that its benefits come from increasing communication in various parts of the brain, also known as neuroplasticity.
The magnetic pulses used in TMS are similar to those used in MRIs. TMS has been used for many years, but its popularity has increased in recent years as a drug-free option in the treatment of various brain and mental health conditions.
TMS is noninvasive, painless, and does not require anesthesia or a recovery room. It does not impair the ability to function. The treatment consists of sitting in a comfortable chair with a magnetic coil positioned next to your head. Then you relax during the 20-minute treatment. The treatment is painless, but you may feel a tingling or tapping sensation on your head. After the treatment is completed you may resume normal activities with no restrictions.
What Conditions can be Treated by TMS?
While research on this innovative device is underway for several conditions, the FDA has approved TMS therapy to treat primary depression that has failed other treatments.
There are several other conditions that have been treated through an “off label” application of TMS as well. Some of the conditions approved for TMS in Europe include:
• Post-traumatic stress disorder (PTSD)
• Chronic pain
• Stroke rehabilitation
• Parkinson’s disease
Clinical depression is the most studied condition treated by TMS. This has resulted in FDA approval of TMS treatment for this debilitating condition. Depression is a common yet serious condition characterized by the persistence of sadness, negative thoughts, and a depressed mood.
Symptoms of Depression
• Persistent sadness
• Inability to focus
• Sleep disturbances
• Low self-worth
• Persistent negative thoughts
• Loss of pleasure in life
• Low interest in things you used to enjoy
• Changes in eating habits
• Suicidal thoughts
Post-traumatic Stress Disorder
Post-traumatic stress disorder (PTSD) is a mental disorder that persists after a person has experienced or witnessed a traumatic or terrifying event. A common misconception is that PTSD just happens to combat veterans; this is not true. Anyone who has experienced a traumatic event may develop PTSD.
Symptoms of PTSD
• Hypervigilance (always looking for danger)
• Feelings of guilt or shame
• Sleep disorders
• Concentration difficulties
• Self-destructive behavior (reckless driving, drinking…)
• Easily startled
Though not as well-researched as depression, there are several studies that conclude that TMS appears to be effective for treatment of PTSD.
Tinnitus (ringing in the ears)
The term tinnitus refers to the perception of buzzing or ringing in the ears. While there are several causes of tinnitus, and each cause has a unique mechanism, it has been found clinically that some cases of tinnitus respond well to TMS with a reduction or elimination of the ringing. Encouraging findings in recent research indicate the therapeutic potential for TMS in alleviating certain types of tinnitus.
Phantom Limb Pain
For those suffering from an amputation, it is common to experience the perception that the limb is still there. Often this perception is felt as pain, known as phantom limb pain. Limited research has been done on the treatment of phantom limb pain with TMS, so each case would be an off-label trial treatment.
Complex Regional Pain Syndrome
Complex regional pain syndrome (CRPS) as its name implies is complex. Its mechanism is poorly understood, but those with this condition certainly understand the pain and infirmity associated with it. CRPS is a chronic pain syndrome that usually develops after an injury, stroke, or surgery. The pain lingers long after the original condition has healed, and the severity of pain is out of proportion to the original injury.
There are studies that indicate TMS may be beneficial to some types of CRPS patients, particularly as an “add-on” therapy to a more comprehensive treatment plan. Patients with CRPS would be treated on a trial basis.
What to Expect at a TMS Appointment
After checking in at the clinic, one of our highly trained providers will meet with you to determine your course of care. If you are a candidate for TMS therapy, you will be asked to remove any items which could be affected by the magnet including ferrous metals and credit cards. You are also provided a pair of earplugs to better relax as the machine makes a clicking sound when in operation.
You will sit in a supportive and comfortable chair while the provider places the magnetic coil at the correct location near your head. You just sit and relax for 20 minutes during the therapy. You may feel a tapping sensation on your head and hear a clicking sound during the treatment, but for the most part, it is restful.
Your initial visit will be a little longer in order to identify the correct location for the magnet and determine your correct dosage.
Who Should NOT get TMS Therapy?
While TMS is an appropriate treatment for many people, certain conditions are contraindicated. Here is a list of contraindications for TMS therapy:
• Metal implants or stents in the brain or neck, including deep brain stimulators or aneurysm clips or coils.
• Metal implants in the eyes or ears
• Shrapnel or bullets in or near the head
• Pacemakers or internal defibrillators
• History of seizures
• Facial tattoos with [metallic] ink that is reactive to magnets
What are the Side-Effects of TMS?
TMS has few side effects and for the most part, is well-tolerated by patients. The most common complaint is a mild headache with treatment. Some patients have also noted scalp irritation and facial twitching. Certainly the most severe, albeit rare, reaction is seizures.
By following treatment guidelines we strive to minimize the risk of side-effects. In fact, one of the benefits of using TMS is that it is not associated with many of the severe side-effects caused by antidepressant medications (weight gain, sexual dysfunction, gut pain and upset, dry mouth, sedation, and depression).
If you suffer from treatment-resistant depression, PTSD, or tinnitus, then TMS is a safe treatment option with a growing body of evidence to support its value. If you have CRPS, or phantom limb pain that resists treatment, you may benefit from this treatment. However, you would undergo an individualized trial treatment to determine the effectiveness of treatment.
As the research uncovers more information about advances in the use of TMS, we will continue to adapt our use of this safe treatment option.
If you are interested in finding out more about TMS or would like to make an appointment at Synapse Human Performance Centers, fill out a patient request form now and get started on your journey to better health.