Frequently Asked Questions
What is TMS therapy?
TMS is a non-invasive form of neuromodulation, which stimulates neurons in the prefrontal cortex by delivering highly focused MRI-strength magnetic pulses. TMS was FDA cleared in 2008 for the treatment of depression in patients who have not benefited or had limited benefit from prior antidepressant medication. Patients undergo treatment five times weekly for approximately six weeks, however it can vary on an individual basis. Patients remain awake and alert throughout the treatment, rendering TMS non-invasive. TMS is also non-systemic, therefore it is virtually free of adverse effects.
Will my insurance cover TMS therapy?
MEDICARE and most major healthcare insurers have a coverage policy for TMS therapy. TMS is most likely covered by your insurance, and our team will assist you from start to finish. Our team can help to quickly evaluate this. You can give us a call directly and we will reply within a 24-hour time period, guaranteed.
What to expect with treatment?
During the treatment, the patient is seated in a reclined position in a comfortable treatment chair with the head supported in a relaxed position. The coil is usually positioned on the left front side of the head, over the part of the brain called the Left Dorso-Lateral Prefrontal Cortex (DLPFC). Short bursts of electricity are passed through the treatment coil, which in turn generate magnetic fields. The magnetic fields have the ability to pass unhindered through the scalp and create small electric currents in the targeted area of the brain. These electric currents depolarize or activate nerve cells in the region of stimulation. Clinical studies have demonstrated that repetitive magnetic stimulation of the DLPFC to be safe and effective in treating patients with depression.
Who are good candidates?
Currently, TMS therapy is FDA approved for the indication of Major Depressive Disorder. TMS should be strongly considered by patients whom have failed to receive satisfactory improvement from prior antidepressant medications and/or have experienced intolerable side effects.
What are the results of TMS Therapy?
TMS 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. Current literature indicates that approximately 50% of all treated patients who meet the above criteria respond to the treatment by bettering their Hamilton depression rating score by 50% or more. The Hamilton Depression rating is a multiple item questionnaire used to provide an indication of depression. Approximately 35% of all treated patients are so called remitters, bettering their Hamilton depression rating score to a score of 7 or less, meaning that they are depression free.
How does TMS work?
This non-invasive therapy stimulates nerve cells in the area of the brain responsible for mood regulation (the dorsolateral prefrontal cortex). Through a treatment coil, the TMS therapy system generates highly concentrated magnetic fields which turn on and off rapidly to stimulate regions of the brain that are thought to be linked to emotion. These magnetic fields are the same type and strength as those produced by a magnetic resonance imaging (MRI) machine. They do not directly affect the whole brain, as they only reach a few centimeters into the brain directly beneath the treatment coil.
How does neuronavigation targeted TMS work?
Neuronavigation Targeted TMS is the future in providing patients with a precise and individualized TMS treatment. Neuronavigation Targeted TMS is an image-based navigation system for targeting TMS to an individual’s unique anatomical features, and matching those features to a “reference database”.
Neuronavigation Targeted TMS provides:
- Shorter treatment time
- Quicker and better results
- Enhanced patient comfort
Is TMS safe and are there any side effects?
TMS is very safe. In clinical trials and in real-life practice TMS therapy is well tolerated and has been proven to be safe. In the US, over 1 million TMS treatments have been performed with low complications and side effects. The most commonly reported side effect related to treatment was mild to moderate scalp discomfort during treatment sessions. Scalp discomfort occurs less frequently after the first week of treatment. If symptoms do persist over-the-counter analgesic may be taken.
Other rarer side effects may include eye pain, toothache, facial muscle twitching, facial pain, or pain of the skin. TMS therapy also produces a clicking sound, so earplugs are provided for each treatment. In the clinical trials, more than 10,000 TMS treatments demonstrated its safety with no occurrence of seizures. However, there is a small risk of a seizure occurring during treatment, estimated at 1 in 10,000. This risk is no greater than what has been observed with oral antidepressant medications.
Note: No side effects such as weight gain, sexual problems, stomach problems, sleepiness, or dry mouth were seen during clinical trials. TMS does not impair memory or the ability to concentrate. Like any treatment option, you and our doctor will discuss the risks and success of TMS therapy and work together to find the most appropriate treatment option for you.
When should TMS therapy not be used?
TMS therapy creates a magnetic field that could cause metal objects near the stimulation coil to move or get heated. Patients with non–removable magnetic-sensitive metals or metallic devices implanted in their head or in body parts near the stimulation coil should not receive therapy with the MagVita TMS therapy system. NOTE: Standard amalgam dental fillings are not affected by the magnetic field and are acceptable in patients.
Any TMS Therapy System should not be used in patients who have an implanted device that may not properly function in the presence of the system, even if the device is located outside the recommended distance. Implanted Electronic Devices and/or Conductive Objects in or near the patient’s head who have an implanted device that is activated or controlled in any way by physiological signals (examples: deep brain stimulators, cochlear implants, and vagus nerve stimulators). Contraindicated use could result in serious injury or death.