June 17, 2018

MedStim: Repetitive Trans-cranial Magnetic Stimulation (RTMS)

Medstim: Treat Depression/ accelerate neuro rehabilitation with non contact magnetic stimulation

Repetitive transcranial magnetic stimulation (rTMS) is a form of brain stimulation therapy used to treat depression and anxiety.The therapy involves using a magnet to target and stimulate certain areas of the brain.

The U.S. Food and Drug Administration approved rTMS as a treatment for major depression when other treatments haven’t been effective. Sometimes doctors use rTMS in addition to traditional treatments.

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Why is rTMS used?

TMS is mainly used to treat severe depression. Repetitive transcranial magnetic stimulation is usually recommended only after medication and psychotherapy fail to work. As patients more and more ask for therapies which allow them to not consume medicines, RTMS is becoming the preferred choice for patients.

The most qualified candidates for rTMS are people with depression who haven’t had success with other methods.

How does rTMS work?

RTMS is a noninvasive procedure. Sessions of rTMS typically last anywhere from a half hour to an hour. During rTMS you will sit or recline while an electromagnetic coil is held near your head. A doctor places the electromagnetic coil against the forehead near the area of your brain that regulates mood. The coil then passes magnetic pulses to a targeted part of your brain. This induces an electrical current in specific nerve cells. It’s thought that these electrical currents stimulate brain cells in a complex way that can reduce depression.

The prefrontal cortex of the brain is often the region doctors choose to target for depression.

What are the possible side effects and complications of rTMS?

Pain isn’t usually a side effect of rTMS. However, people may describe the sensation of the magnetic pulse as uncomfortable. Some people describe this as a knocking or tapping feeling with each pulse. The electromagnetic pulses can cause muscles in the face to tighten or tingle.

The procedure is associated with mild to moderate side effects, including:

  • feelings of lightheadedness
  • temporary hearing problems, due to the sometimes loud magnet noise
  • mild headaches
  • tingling in the face, jaw, or scalp

Though rare, rTMS does come with a small risk of seizures.

How does rTMS compare to ECT?

Several therapies exist that involve stimulating the brain in different ways. Electroconvulsive therapy (ECT) is one such treatment. ECT involves placing electrodes on strategic areas of the brain and creating an electric current that essentially causes a seizure to occur in the brain. The procedure is performed under general anesthesia. Doctors also give the person undergoing ECT a muscle relaxant to keep them from shaking during the stimulation portion of the treatment. This differs from rTMS because people receiving rTMS don’t have to receive sedation medications. Not requiring sedation is beneficial because it reduces the risks for potential side effects.

One of the other key differences between the two is the ability to target certain areas of the brain. When the rTMS coil is held over a certain area of the brain, the impulses travel only to that part of the brain. Electroconvulsive therapy is unable to target specific areas.

While doctors use both rTMS and ECT to treat depression, ECT is usually reserved for patients with severe and potentially life-threatening depression. Other conditions that ECT may be used to treat include:

  • bipolar disorder
  • schizophrenia
  • suicidal thoughts
  • catatonia (when a person isn’t responding to others or their surroundings)

Who should avoid rTMS?

There are some people who can’t get rTMS, even if they could benefit from it. The magnetic coil used in the treatment can be dangerous for anyone who has metal implanted somewhere in their head or neck.

Examples of people who shouldn’t get rTMS include those with:

  • aneurysm clips or coils
  • bullet fragments or shrapnel near the head
  • cardiac pacemakers or implantable cardioverter defibrillators (ICD)
  • facial tattoos that have magnetic ink or ink that is sensitive to magnets
  • implanted stimulators
  • metal implants in the ears or eyes
  • stents in the neck or brain

A doctor should conduct a thorough examination and take a medical history before using the therapy.