We are often asked how does TMS work and how does TMS work to help depression? This article was written to help provide a better understanding of how TMS works to treat chronic and severe depression. TMS otherwise known as Transcranial Magnetic Stimulation uses an electromagnet to create magnetic pulses. A coil is used to generate the magnetic pulses and is placed on your scalp towards the frontal part of the brain. Magnetic pulses pass through nerve cells to stimulate that part of the brain that controls mood and depression. It is thought that the depression may have caused this part of the brain to become inactive over time. TMS is a very focused treatment that helps reignite the nerve cells here.
A TMS machine is used to create the magnetic fields which are generated at different speeds. The strength of these magnetic forces are similar to that of an MRI machine. When placed on the scalp, the magnetic pulses can stimulate the targeted area within the brain, which is approximately the size of a ten cent coin. Settings can generate a slow pulse, for example 1hz (one pulse per second) or a fast pulse 10 Hz (ten pulses per second). A slow pulse is used to reduce the activity in the underlying brain and a fast pulse used to activate the underlying brain. Both techniques can be useful depending on which part of the brain they are applied to.
In contrast to other forms of brain stimulation such as ECT (electro convulsive therapy) and DBS (deep brain stimulation). TMS does not require surgery. Nor does it require hospitalisation. It is a very well tolerated treatment for depression with very few side effects. For a closer comparison on other depression treatment forms please click here.
During the first visit, various measurements are taken to ensure that the TMS coil will be positioned in the correct position over the client’s head. The TMS coil is then held by the technician over the patient’s scalp. The technician then measures the patient’s motor threshold. The motor threshold is the minimum amount of power necessary to make the patient’s thumb twitch. This is different for each individual and the technician will know the intensity required to stimulate the individual’s brain cells.
After setting up the patient and machine in the correct position, the treatment usually last about 40 minutes and after the treatment is finished the person can go about their everyday duties.
At Sydney TMS we are constantly monitoring TMS protocols both in Australia and Internationally to offer the most up to date treatments available. In addition, our clinics regularly share knowledge and information with other TMS providers around Australia through the Royal College of Australian and New Zealand College of Psychiatrists network.
While TMS technology has been applied and researched for many conditions including psychiatric conditions, addictions, neurological conditions and others, our clinic focuses only on treating those disorders where an well established treatment protocol has been developed. Typically this means, that these protocols have been rigorously studied and are endorsed by a professional body or government agency internationally.
To create a sustained effect of the brain, stimulation needs to be repeated over a series of treatment sessions. The most accepted coarse of treatment is between 20-30 sessions. Typically, these are best delivered daily Monday to Friday for 4-6 weeks.
There is now an extensive body of research supporting the effectiveness of the therapy in the treatment of major depressive disorder. Patients who have major depression and resistant to antidepressants should consider it. Research suggests that 50% of patients will experience an improvement in depression symptoms after TMS treatment. At Sydney TMS, we closely monitor our results and have found that we have a 60% response rate. When you compare this to 30% response rate for antidepressant medication treatment, you can appreciate that TMS can play a very important role in treating depression.
For further information about Sydney TMS and our approach please contact us on 1300 177 144. We look forward to hearing from you.