What is TMS?

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Depression becomes the most common illness by affecting more than 264 million people worldwide. Depression is discrete from normal mood swings and momentary emotional reactions to daily life problems, particularly when moderate and long-lasting or severe intensity, depression may become a serious health condition. Different mental health conditions such as depression, stress, and anxiety are mounting up globally. A World health assembly passed a resolution in May 2013 for a complete and coordinated response to address mental problems at the national level.

Psychosocial treatments are beneficial for mild depression. For effective treatment of severe and modern depression, use of antidepressants is good but those are not used to treat mild depression. On the other hand, it’s also evident that sometimes antidepressants or medications leave some symptoms even after the treatments. In that case, it is advised to go for Transcranial Magnetic Stimulation (TMS).

What is Transcranial Magnetic Stimulation (TMS)?

Transcranial magnetic stimulation, or TMS, is a non-invasive form of brain stimulant. TMS devices work exterior leads to the body and influence the central nervous system's activities by applying strong magnetic fields to particular brain areas associated with depression. Anaesthesia is not necessary for the TMS treatment, and it is generally tolerated compared to the side effects often seen with medications and ECT.

How does TMS work?

TMS is a neuromodulatory technique that delivers continuous magnetic pulses using a ‘coil’ to the brain. An electric current is supplied to the coil, which executes a magnetic field generator. The produced magnetic field impels an electrical current in the brain. There are various types of coils in use to obtain different magnetic field patterns, and using more focal points can obtain an intense magnetic field to trigger deeper cortical layers. Stimulant is typically applied at a required intensity to stimulate action potentials in proximate neurons. Applying continuously many TMS pulses in a row is called repetitive TMS or ‘rTMS.’ The pulses’ timing can determine how the brain changes in response.


Is TMS really effective?

It is noted that 50% to 60% of people with depression who have tried and failed to benefit from medications experience a clinically meaningful TMS response. On the other hand, the effect of TMS depends on a few other factors, and they are as follows:

  • Frequency, length of treatment, intensity, and pattern of the pulses
  • Treating different areas of the frontal cortex (left/right/both dorsolateral prefrontal cortex and the anterior cingulate cortex)
  • Number of weeks of treatment
  • Number of treatments per day
  • Types of patients appropriate for treatment
  • The maintenance schedule for patients who respond well to treatment.

What are the side effects of TMS?

TMS treatments have mild to moderate side effects that go away after one session and can be reduced over time with more sessions.

  • Headache
  • Scalp discomfort at the site of stimulation
  • Tingling, spasms, or twitching of facial muscles
  • Light-headedness

Depending on the patient, the effects can be more complicated, and they can be:

  • Mania, particularly in people who have bipolar disorder.
  • Seizures
  • Hearing loss if there is inadequate ear protection during treatment.

Other potential side effects include transient confusion related to disruptions in cognition, hearing, or vision.


Who cannot get TMS therapy?

TMS is not suitable for several other types of patients. Since TMS uses magnetic energy, people who have metal in their head or neck cannot receive TMS, except braces or dental fillings.

There are metal implants that would meddle TMS treatment include:

  • Deep brain stimulants
  • Shrapnel or bullet fragments
  • Aneurysm clips
  • Metallic ear/eye implants
  • Stents
  • Pacemakers

Along with these factors, some more factors that can stop you from receiving TMS therapy includes:

  • Having a medical history of other mental illness or indulgence in substance abuse or psychosis.
  • Brain tissue damage from diseases and injury, such as a traumatic brain injury, brain tumour, or stroke.


What do you expect from TMS?

A typical TMS treatment course includes daily sessions (5 times per week) for 4 to 6 weeks— some patients go for TMS treatment occasionally after the initial treatment session. A TMS session duration is 20 to 40 minutes, although some new devices made sessions as short as 3 minutes.

  • Short electromagnetic pulses are then conducted through the coil. The magnetic pulses easily penetrate through your skull and create small electrical currents that stimulate nerve cells.
  • Patients hear clicking sounds and feel a tapping, knocking, or tingling sensation in their heads.
  • Patients can feel discomfort in the scalp while taking treatment or afterward for a short time.