TMS is a method that stimulates neurons in the brain. With this treatment method, brain activity is changed with a strong but short magnetic field from the outside. Electric currents induced in tissues by rapidly changing magnetic fields cause stimulation. In this way, brain activity can be triggered or modulated without the need for external electrodes and surgery. In this respect, the TMS method, which maps the functioning of the brain, is seen as a very powerful tool in terms of research and diagnosis in neurology.
Repetitive, transcranial magnetic stimulation, ie tTMS, is promising in the treatment of disorders such as anxiety disorder and depression. For this reason, it is an alternative and very good option to ECT. The magnetic pulses used in this method pass through the patient’s skull painlessly and stimulate the brain cells that will provide communication between parts of the brain. Although it is not known exactly how the method works, stimulation appears to have a lasting effect that can alleviate the symptoms of depression.
In Which Types of Diseases TMS Can Be Used?
In the USA, transcranial magnetic stimulation therapy has only been used to treat major depressive disorder. TMS therapy is a method used in cases where treatments such as medication and assistance techniques are ineffective or in the case of medication, severe side effects are seen. In this regard, TMS has been approved in many European countries under the following conditions:
- Post Traumatic Stress Disorder,
- Anxiety disorders such as OCD,
- Stroke rehabilitation,
- Alzheimer’s disease,
- Parkinson’s disease,
- Nicotine addiction,
- TMS is a method that can be easily applied in diseases such as chronic pain.
Who should not be applied to TMS?
There is no medical or psychological condition that would prevent the application of TMS treatment. However, there are some situations that are not recommended to be applied due to insufficient research and attention. One of these situations is people with an epileptic history. In addition, a research on the application of dental implants, vagus nerve implants, dental prostheses, ear implants, pacemakers, any prosthesis, heart stent, patients who have had heart valve replacement, those who have an insulin pump or who have had a shunt operation due to any brain disease and broadcasting is out of the question. Therefore, it should not be used in such people. Other than that, there is no situation that is strictly prohibited to use.
How is TMS Treatment Applied?
TMS treatment is usually done in a doctor’s office or clinic. It also requires a series of sessions to be an effective treatment. Sessions are also held daily, five times a week for four to six weeks. Just before TMS treatment begins, your doctor will need to identify the best area to place magnets on your head. Your first session will take approximately 60 minutes, during which you will be taken to the treatment room and asked to sit on a reclining chair. Headsets will be given to wear during the procedure. Then an electromagnetic coil is placed on your head and this coil will be turned off and on repeatedly in order to generate stimulating pulses. This typically results in a tapping or clicking sound that lasts for a few seconds and then a pause. You will also feel a touch sensation on your forehead.
Your doctor will determine the amount of magnetic energy required by increasing the magnetic dose until your fingers or hands twitch. This is used as a reference point in determining the right dose for you. During TMS therapy, the amount of stimulation can also be changed depending on your side effects and symptoms.
What Are the Common Side Effects of TMS Treatment?
Side effects seen in TMS treatment are generally mild or moderate side effects. These effects also improve after a short time after the session and decrease over time with other sessions. Common side effects in treatment can include:
- Scalp discomfort at the stimulation site,
- Tingling, twitching or spasms of facial muscles,
What Are the Uncommon Side Effects in TMS Treatment?
These kinds of side effects are rarely seen in TMS treatment. These can include:
- Hearing loss (if ear protection is insufficient during treatment),
- Mania (in people with bipolar disorder).
When Does TMS Treatment Respond?
In TMS treatment, improvement is observed within two weeks at the latest from the start of treatment. Some of the patients notice the therapeutic benefit starting from the second week of treatment.
In order to achieve significant reductions in depression symptoms, late responders may need additional sessions on the third week. Patients enter maintenance therapy approximately 8-12 months later. However, this time period also varies according to each patient. Maintenance therapy is, on average, half of the number of sessions of tTMS that were originally completed.
How Long Does TMS Treatment Have on the Person?
Studies on the duration of the effect of TMS treatment reveal different information from each other. According to some studies, the effect of this treatment is quite short. In other words, there is no clarity in terms of accelerating the effect and having an effect for a long time. However, the treatment makes a direct and indirect contribution to the drug treatment that the person has already used. After the drug resistance is eliminated in TMS treatment, the person continues the classical protocol and drug therapy. However, TMS treatment applied alone is not a recommended approach. Because the purpose of this treatment is to accelerate and strengthen the existing treatment.