rTMS vs TMS. What’s the difference?

There are many terms used in depression treatment, like rTMS vs TMS that can be puzzling when starting our your own research.

TMS is a relatively recent and significant advancement in noninvasive brain stimulation, previously serving as both a diagnostic and therapeutic tool. Recently, its application has shifted more towards treating psychiatric illnesses by stimulating the brain’s outer layer.

When exploring TMS, you might encounter numerous confusing acronyms. What is TMS? What is rTMS? What about dTMS, tDCS, tACS, tRNS, ECT, VNS, and DBS?

It can be overwhelming sifting through all of this while you’re already struggling with your mental health.

This article aims to clarify these terms for a better understanding. These are all forms of brain stimulation using various methods to try and change brain activity to treat a particular condition.

TMS: TMS or transcranial magnetic stimulation is the broad area or concept of using magnetic fields to non-invasively stimulate specific brain regions (1).

rTMS: rTMS or repetitive transcranial magnetic stimulation is commonly used for psychiatric conditions. It delivers repetitive magnetic pulses with a TMS device to induce longer-lasting changes in brain activity. This is what we provide at Sydney TMS (2).

dTMS: dTMS or Deep TMS targets deeper brain structures than conventional brain structures. The research on dTMS is still in its early days, but it doesn’t appear to be inferior to rTMS (3).

tDCS: tDCS or Transcranial Direct Current Stimulation modulates brain activity by delivering a low electrical current to the brain through electrodes on the scalp (4).

tACS: tACS or Transcranial Alternating Current Stimulation applies oscillating electrical currents to influence brain activity (5).

tRNS: tRNS or Transcranial Random Noise Stimulation uses random electrical noise to try and influence brain function (6).

ECT: ECT or electroconvulsive therapy has historically been the most well-known neuro-stimulation technique and involves running an electrical current through the brain to induce seizures.  It is generally accepted to be effective for over 70% of people, but does involve going under anaesthetic, and has a risk of causing problems with your memory (7).

VNS: VNS or Vagus Nerve Stimulation is a device implanted under the skin that sends electrical impulses to the brain via the vagus nerve, often used for epilepsy, depression, anxiety, and PTSD, and is less common than TMS (8).

DBS: DBS or Deep Brain Stimulation involves a surgically implanted set of electrodes in the brain to deliver electrical impulses to specific areas. Often used for movement disorders like Parkinson’s disease (9).

So, the difference between TMS and rTMS specifically is simple. TMS is the general concept of stimulating the brain with an electromagnetic field, and rTMS is a specific method of using TMS pulses repetitively to create change in brain activity to treat mostly psychiatric conditions. rTMS is what we provide at Sydney TMS.

We hope this has given you a clear idea of what all these acronyms mean, and what rTMS is as opposed to other forms of brain stimulation.


1. Black Dog Institute. What is Transcranial Magnetic Stimulation treatment for depression? Explained – Black Dog Institute [Internet]. Black Dog Institute. 2021 [cited 2024 Feb 13]. Available from: https://www.blackdoginstitute.org.au/news/what-is-transcranial-magnetic-stimulation-treatment-for-depression-explained/

2. Mann SK, Malhi NK. Repetitive Transcranial Magnetic Stimulation [Internet]. NCBI Bookshelf. 2023 [cited 2024 Feb 13]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK568715/

3. Miami G. What Is Deep TMS Therapy? [Internet]. GIA Miami. 2022 [cited 2024 Feb 13]. Available from: https://gia.miami/rehab-blog/what-is-deep-tms-therapy/

4. Thair H, Holloway AL, Newport R, Smith AD. Transcranial Direct Current Stimulation (tDCS): A Beginner’s Guide for Design and Implementation. Frontiers in Neuroscience. 2017 Nov 22;11.

5. Elyamany O, Leicht G, Herrmann CS, Mulert C. Transcranial alternating current stimulation (tACS): from basic mechanisms towards first applications in psychiatry. European Archives of Psychiatry and Clinical Neuroscience. 2020 Nov 19;271(1):135–56.

6. Moret B, Donato R, Nucci M, Cona G, Campana G. Transcranial random noise stimulation (tRNS): a wide range of frequencies is needed for increasing cortical excitability. Scientific Reports. 2019 Oct 22;9(1).

7. The Royal Australian & New Zealand College of Psychiatrists. Electroconvulsive therapy (ECT) [Internet]. RANZCP. 2019 [cited 2024 Feb 13]. Available from: https://www.ranzcp.org/clinical-guidelines-publications/clinical-guidelines-publications-library/electroconvulsive-therapy-ect

8. The Royal Children’s Hospital Melbourne. Neurology : Vagus nerve stimulation [Internet]. The Royal Children’s Hospital Melbourne. [cited 2024 Feb 13]. Available from: https://www.rch.org.au/neurology/patient_information/vagus_nerve_stimulation/

9. Mayo Clinic. Deep brain stimulation [Internet]. Mayo Clinic. 2023 [cited 2024 Feb 13]. Available from: https://www.mayoclinic.org/tests-procedures/deep-brain-stimulation/about/pac-20384562