Commonly asked questions about Transcranila Magnetic Stimlation (TMS) answered by Dr. Daniel Press, Director, TMS Clinical Program at Beth Israel Deaconess Medical Center:
What is TMS?
TMS stands for Transcranial Magnetic Stimulation. It uses magnetic fields to induce a current in specific brain areas and thus stimulate or suppress brain activity. Using TMS allows doctors to change brain activity without surgery and with minimal discomfort to the patient. TMS has been used to treat a variety of disorders including migraines, stroke, Parkinson's disease and depression.
Who is a good candidate for TMS for depression?
In 2009, the Food and Drug Administration approved the NeuroStar TMS Therapy system for treatment of people with major depressive disorder who haven't seen satisfactory improvement from medication. As with any treatment option, you and your doctor should discuss if TMS therapy is right for you.
What are the sessions like and how many are needed?
During each TMS session, patients sit comfortably in a chair. The stimulation coil (wand) is held just above the head, targeting magnetic pulses to a 2-3 centimeter area of a specific area of the brain. The nature of the magnetic fields allows them to pass through the patient's hair, skin and skull and into the mood-regulating area without being distorted in any way. Patients do not require anesthesia or sedation.
In the brain, these magnetic pulses produce small electrical currents. The electricity created in the brain cannot be felt by the patient, but is sufficient to change the activity of brain cells. Applied repeatedly, these magnetic pulses modify the activity of the targeted brain area and can thus help the brain overcome the dysfunction associated with depression. Treatments last for about 40 minutes and occur every day for a period of several weeks.
Is it safe?
TMS is a safe treatment for depression if appropriate guidelines are followed. In more than 10,000 treatments administered in clinical studies, the most common side effect was mild-to-moderate scalp pain or discomfort at the treatment area, which declined "markedly after the first week." Fewer than 5 percent of patients stopped treatment due to adverse effects. There is a very small risk of seizure - about the same risk as when taking medications to treat depression.
Does it work?
In clinical studies involving hundreds of people with major depressive disorder, significant improvement was recorded for symptoms of core depression, anxiety, and other forms of psychological distress. In most patients, benefits lasted through the 6-month study follow-up period. While NeuroStar TMS Therapy has been proven effective, not all patients will benefit. Patients should be carefully monitored for worsening symptoms.
Will my insurance cover it?
While the treatment was recently FDA approved, not all insurance companies yet cover the treatments. Our staff will assist you in contacting your insurance company about coverage.
Where do I call for more information?
Call the TMS Clinical Program at the Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center at 617-667-0303.