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Bogdan Mikhailuk

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TMS

What is TMS Therapy?

Transcranial Magnetic Stimulation (TMS) is a series of brief, repetitive, and highly focused magnetic pulses that are used to stimulate particular areas in the brain. It is a highly effective, non-invasive, and is without systemic side effects.

TMS exerts its magnetic energy on the electrical impulses with the length of a nerve cell that has been activated. With neurotransmitters released, it communicates with relating nerve cells, creating an electrical impulse in other cells. Neurochemical or rather electrochemical deficiences in particular areas of the brain are believed to be reduced in patients suffering from depression. Position Emission Scans (PET) scans show reduced activity in the brains of persons suffering from depression compared to the brains of persons not suffering from depression. TMS uses an electromagnetic coil to create safe magnetic pulses that are delivered specifically to targeted areas of the brain. This in turn, increases inherent electrical currents in the brain that stimulates the nerve cells to increase the neurochemical or rather electrochemical activities in the brains of depressed persons to a normal level.

Why is TMS Different than Medications?

The brain is neurochemical or rather electrochemical in nature.TMS delivers safe magnetic pulses that increase inherent electrical activity and subsequent neurotransmitter release that is present in all brain cells. Antidepressants exert their effects on the chemical release of neurotransmitters at the connections between neurons i.e. the synapse. Antidepressants circulate in the bloodstream prior to crossing the blood brain barrier to exert their effects and may have bothersome or potentially significant acute and long term side effects. Historically, antidepressants side effects had to be tolerated or other medications used to counteract side effects when possible. More recently antidepressant treatments have required the use of antipsychotic medication as add on or augmentation therapy to increase the possibility of antidepressant response. This class of medications can cause weight gain and/or metabolic issues ( increased lipids or sugar in the bloodstream) or in some cases tardive dyskinesia which is a bothersome neurological syndrome that can be pervasive and in some instances not completely reversible. The independent NIMH ( National Institute of Mental Health) studies reveal that the more antidepressant trials a patient fails the less likelihood there will be remission of symptoms. Transcranial Magentic Stimulation response and remission rates are markedly higher than with antidepressant and other medications that might be used to increase the probability of response and remission.

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How Does Transcranial Magnetic Stimulation Work?

Transcranial Magnetic Stimulation (TMS) safely delivers magnetic pulses to specific parts of the brain that are responsible for regulating mood. Rather than the use of invasive, disruptive and potentially damaging electrical currents as with ECT(electroconvulsive therapy), the magnetic pulses of TMS are the same as those released in an MRI. More specifically in the treatment of resistant depression, the left dorsolateral prefrontal cortex of the brain receives pulses which interact with deeper areas of the brain have improved signal transmission and connectivity which has been shown in the brains of depressed patients. . TMS offers sustained relief to the majority of patients and nearly half of which achieve complete remission without medications. As show in the independent National Institutes of Mental Health ( NIMH) clinical studies with TMS for treatment resistant depression. Many of our patients choose to remain on medications during treatment as more recent studies have shown greater possibility of obtaining a more robust response and/or higher likelihood of complete remission. If there are medications in use that are not particularly bothersome or problematic then the decision is often made to continue medications along with TMS.

Advantages of TMS Therapy

  • No anesthesia required, non-invasive, no electrical current is administered.
  • The patient can resume normal activities after treatments and drive themselves to and from treatment sessions
  • Proven efficacy,sustained treatment response and/or possibility of complete remission with or without continued use of medications.
  • No systemic side effects i.e. weight gain, metabolic issues( increased lipids or blood sugar levels), sexual dysfunction, irreversible neurologic conditions, i.e. tardive dyskinesia as with medications used to treat resistant depression.
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