Taking A Closer Look At TMS
January 6, 2021
Thinking about starting a new treatment method can be scary--especially when it involves heavy-duty machinery. Not quite so mainstream yet--in addition to sporting some serious metal-- Transcranial Magnetic Stimulation fits that description.
Still, most people who have heard of TMS only have an idea of what treatment looks like. Because of that, it’s common for the imagination to build new things up to be more intimidating than they really are. Here’s a comprehensive look at TMS and the machine that makes it possible.
A Brief History Of TMS
While Transcranial Magnetic Stimulation (TMS) is considered an up and coming method of treating mental and neurological ailments, it’s been around for a while.
The idea of using magnetic force to heal goes back to the 1790s when scientists Luigi Galvani and Alessandro Volta (the fathers of electrophysiology and bioelectric theory) first discovered that nerves carry electrical currents.
Scientists began to experiment with implementing electric and magnetic stimulation into the physiological realm. From this significant discovery, they discovered how it affects brain function and muscle movement.
Fast forward a couple hundred years, researchers looked beyond the physical and started moving towards the psychological. In 1985, Dr. Anthony Barker created what we now know to be TMS.
Using the very first TMS machine, he, along with his colleagues, produced magnetically stimulated hand twitches in localized areas. This was important because it showed the machine’s ability to isolate different parts of the brain.
Dr. Barker and his fellow scientists were so adamant about the safety and potential of the apparatus that they conducted clinical trials on volunteers while they were wide awake--the results proved painless.
In the 1990s, TMS had shown to be entirely safe for treating mental illness. Eighteen years later, the FDA agreed, approving it for treatment-resistant depression.
Since then, more research continues to prove its value in treating other mental and neurological disorders. In the meantime, it’s already changed countless lives.
Who Is TMS For?
When looking to manage mental illness, we typically hear about psychotherapy and medication--but what if that’s not enough? While these widely respected treatment methods have a profound ability to heal, they don’t work for everyone.
As anyone who’s sought help for their mental illness knows--remedies aren’t one-size-fits-all. For example, when thinking about medication, we understand that not everyone will respond in the same way. The same goes for treatment modalities.
Transcranial Magnetic Stimulation is typically used when talk therapy and medication haven’t done enough to curb symptoms. Many people who give TMS a try use it to augment talk therapy and medication. However, it can function as a stand-alone treatment. It’s also an excellent option for those who have adverse reactions to SSRIs, like increased depression and weight gain.
If that sounds familiar, you might consider trying it.
But who is TMS meant for, specifically? Here are some mental illnesses that improve with Transcranial Magnetic Stimulation--
- Treatment-resistant depression
- Obsessive-Compulsive Disorder
- Posttraumatic Stress Disorder
It’s important to note that the above illnesses are what TMS is generally advertised for. Still, it’s just as capable of treating other ‘off-label’ conditions. Some include--
- Anxiety Disorders
- Bipolar Disorder
TMS is thought to be exclusively for mental illness but has done a lot to help people suffering from chronic and degenerative neurological concerns, like Multiple Sclerosis, Migraine/Chronic Pain, and even Alzheimer’s.
What Does TMS Do, Exactly?
We know where it came from and who benefits from TMS. Still, the central factor in decision-making is understanding what it does to the brain, and more importantly, mental illness.
Using magnetic pulses, TMS targets the areas of the brain responsible for emotional regulation. Those pulses encourage the mind to form new neural connections, and as a result, alleviate depressive symptoms.
The scientific community still isn’t entirely sure how the stimulation and neural connections change brain chemistry. Even so, they seem to have the practice down to a science.
The lack of understanding shouldn’t be a cause for concern, but instead, excitement. Given its success rate and lack of side-effects, more knowledge will only uncover new uses and impactful scientific discovery.
Take It From A Scientist
Neurologist Alvaro Pasqual-Leone has dedicated his time exploring TMS’s effects on various conditions. Specifically, he’s known for partnering up with his subject, John Robison, in using TMS for treating Asperger’s Syndrome.
In an interview with NPR, Pasqual-Leone gave listeners insight into the treatment method’s potential and its different applications. When asked about depression, Parkinson’s, stroke, and autism, he says--
“There are two very different goals in those applications. The first set of goals is to understand better how the brain works in those conditions in patients that have those diseases. Part of the reason we want to understand it better is so we can develop new ways to diagnose the conditions earlier...and develop new treatments.”
According to Pasqual-Leone, it seems that we’re in an exciting period when it comes to TMS. The more we explore magnetic stimulation, the more we can both prevent and treat different ailments. How cool is that?
How Does TMS Work?
The machine above may look intimidating, but rest assured, it’s nothing to be afraid of. Actually, it’s quite a benign thing. Here’s what it does:
Using a coil placed on the outside of the scalp, an electromagnet painlessly transfers magnetic pulses from the apparatus to the brain. The coil is attached to a hose so that it can be adjusted according to scalp size.
As for the pulses themselves, they consist of highly concentrated magnetic fields that rapidly turn and off. The fields don’t affect the brain in its entirety, only a few centimeters below where the coil is positioned. Specially trained practitioners are responsible for making sure everything is in the correct place.
How Does It Measure Up To Other Machines?
TMS machines are similar to MRI structures. Both apparatuses are non-invasive and painlessly track brain activity in specified areas. But what separates the two is what happens next.
MRI, EEG (electroencephalography), and MEG (magnetoencephalography) are handy when diagnosing illnesses, but they can’t do much else.
TMS, on the other hand, can be used for diagnosis, as well as treatment. It’s the only recording method that can also turn parts of the brain ‘on’ and ‘off.’
Differentiating Between The Machines
It’s common to see different words and letters attached to the TMS acronym when looking into treatment facilities. Many people think all TMS to be the same, and to an extent, they’re correct. But it also varies. Let’s learn more about what’s available!
Standing for repetitive Transcranial Magnetic Stimulation, rTMS was the first iteration of the treatment method approved by the FDA--it’s also the most popular method.
rTMS uses repetitive magnetic pulses at the same rate for surface TMS. That means the magnetic pulses are more local, stimulating the outer cortex of the brain.
The coil on this machine is relatively small, making it easy for technicians to be aware of its placement.
This is TMS’ second wave. Approved by the FDA in 2013, some practitioners consider this version of the treatment more effective than its premiere prototype. The idea of this method is to reach structures that exist farther into the brain. Because of this, Deep TMS was approved by the FDA not only for persistent depression but Obsessive-Compulsive Disorder.
And instead of a small-adjustable coil, the patient wears a helmet for the duration of each session.
Deep TMS also differs from traditional TMS in timing. A standard rTMS session takes about thirty-seven minutes, while Deep TMS lasts only twenty.
Choosing a treatment that’s right for you is a highly personal process. There’s a lot of information out there on medication and psychotherapy, so we figured we’d give more insight into one more you may have missed. It might not be as well-known, but it just might change your life. We hope it helps!