TMS Advances

TMS Could Offer Relief from This Nervous System Condition

July 31, 2019

Tardive dyskinesia is a nervous condition that sometimes occurs as a side effect of antipsychotic drugs, resulting in involuntary movement of the face, neck, and tongue. Though there are ways to treat the condition, the medical community has yet to establish an immediate cure for it. 

However, a recent study indicates transcranial magnetic stimulation (TMS) may alleviate symptoms of tardive dyskinesia. 

Continue reading to find out more about:

  • Tardive dyskinesia: What it is, and how it develops
  • The study: Its background, results, and their significance 
  • TMS: How it works, and what it’s used for 

Tardive Dyskinesia 

What is it?

As previously stated, tardive dyskinesia (TD) is a movement disorder that manifests primarily in the facial region but can affect other parts of the body as well. 

Symptoms of TD include: 

  • Facial grimacing 
  • Sticking out the tongue
  • Fisk-like movements of the mouth
  • Puckering lips
  • Excessive blinking
  • Twisting the neck or torso 
  • Waving arms 
Patients exhibit symptoms of tardive dyskinesia
This figure shows patients exhibiting the various symptoms of TD. Image courtesy of Semantic Scholar.

Cases of TD range from mild to severe. Approximately 60 to 70 percent of cases of TD are mild and only around 3 percent of cases are extremely severe. In the latter 

Severe cases may involve problems such as difficulty swallowing, speech interference, disfigured facial features, and breathing trouble.

How does it develop?

According to the National Alliance of Mental Illness, tardive dyskinesia is “a serious side effect that may occur with certain medications used to treat mental illness.” 

Patients who take antipsychotic drugs, which treat disorders like schizophrenia and bipolar, are at risk for developing TD because of the drug-related dopamine interference. 

While TD is usually a result of long-term use of antipsychotics, but it has been known to occur after a shorter period of time as well. 

You are more likely to develop TD if you: 

  • Have gone through menopause, or are over the age of 55
  • Abuse drugs or alcohol 
  • Are of African or Asian descent 

The Study: Treating TD with TMS

Background

The inspiration for the study occurred when a patient entered the researchers’ hospital for treatment of severe neuroleptic malignant syndrome (NMS). MD Magazine states “[the patient] was treated with rTMS as a last resort since it was reported to be successful in Parkinson’s disease treatment. The patient regained normal gait after 5 sessions per week for 4 weeks.” 

Because NMS is similar to TD in that it is caused by antipsychotic drugs and affects movement, the researchers hypothesized that TMS could also work to treat TD. 

Results

Using the Abnormal Involuntary Movement Scale (AIMS), the researchers tested 52 subjects to see whether TMS improved their symptoms of TD. 

The researchers found that TMS improved the patients’ AIMS scores, as well as overall severity, incapacitation, and awareness. 

Significance  

Following the study, researchers concluded that “[TMS] might be a feasible treatment for patients with tardive syndromes unresponsive to ‘first-line’ medical treatment.” 

Currently, doctors have no real way to treat TD, other than lowering the medication dosages, adding another medication, or switching to a different medication. There are claims that supplements such as vitamins B6 and E and melatonin can help ease symptoms, but nothing had been proven. Therefore, the study suggests TMS could be the most effective treatment option for TD. 

A Closer Look at TMS

How does it work?

TMS uses an electromagnetic coil to emit pulses and stimulate neurotransmitters, like dopamine, in the brain. The magnet used during a TMS treatment is similar in strength to that of an MRI machine. 

Cartoon image shows TMS penetrating brain with magnetic force
The magnetism used in TMS is thought to excite particles in the brain, including those that affect mood and movement. Image courtesy of Eugene Weekly

Though TMS generates internal results, it is not an invasive process, meaning the patient does not need to undergo anesthesia in order to receive the treatment. After a TMS session, the patient can resume daily activity as normal and drive themselves home or return to work or work. 

In order to produce lasting effects, TMS must be administered four to five days a week for around six weeks. Most sessions last approximately thirty minutes, but that time may be less or more depending on the patient. 

What is it used for?

TMS is FDA-approved to treat major depressive disorder (MDD). Many patients with MDD experience symptoms that are resistant to medication and therapy, and TMS is emerging as an alternative form of treatment that can reduce depression’s severity or even, in some cases, alleviate its symptoms entirely. 

In the United States, TMS is only being used to treat depression so far. However, studies, such as the one involving TD, are being done to test TMS’s effectiveness in treating other disorders and conditions. 

These disorders and conditions include:

Authors of the TD study believe theirs “is the first study to suggest that repetitive transcranial magnetic stimulation may offer a possible treatment for tardive dyskinesia and related tardive syndromes.” 

Woman crosses bridge
Expansion seems inevitable for TMS, as studies testing its effectiveness are so widespread and encouraging. 

In addition to its results, part of the reason TMS is such an appealing treatment prospect is its comparative lack of side effects. This separates it from the majority of medications in use today, most of which contain the risk of side effects. 

Conversely, TMS has little to no side effects. However, some patients do experience slight head pain after initial treatment sessions but any discomfort should be short-lived and mild. 

Moving Forward

Because this study is among the first experiments involving TMS and TD, there remains much to be discovered regarding the relationship between TMS and TD. But due to the researchers’ positive results, it is likely more investigation will be done, which is a hopeful sign for those who suffer from TD. 

If you take antipsychotics and think you might be showing signs of TD, contact your doctor as soon as possible. Sometimes, changing the dosage of your medication is enough to relieve symptoms. 

Additionally, if you have been struggling with depression despite taking medication and seeing a therapist, ask your doctor about TMS—it’s covered by most insurances!

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