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Improved Transcranial Magnetic Stimulation (TMS) Procedure

 

transcranial-stimulation
Source of image: Dreamstime

What Is Transcranial Magnetic Stimulation? :

Transcranial magnetic stimulation is normally abbreviated as TMS. Essentially, this treatment works by delivering short pulses of magnetic energy (which are generated by a handheld device that contains an electromagnetic coil) to specific brain regions. It is a non-physically invasive therapy and the smallish, relatively simple device is merely guided over the relevant areas of the patient’s head by the doctor.

Research has already shown that the treatment can significantly reduce depressive symptoms in patients and early indicators are that it may also be of benefit to individuals suffering from the effects of trauma.

In order to help you visualize the simplicity of the procedure, imagine a hair-dryer being moved over the head – the only difference is that, rather than warm air being delivered, essentially painless, magnetic pulses are delivered instead.

HOW DOES TMS WORK?

I have already stated that the procedure is essentially painless (although some patients report that it has induced in them a headache) so the magnetic pulses are delivered whilst the patient is fully conscious. The procedure generally takes about twenty minutes. The magnetic pulses work by altering the way in which the brain cells communicate with each other (or, to put it more technically, the electrical firing between the brain’s neurons is altered) in the specific brain regions at which the treatment is directed. Research into the treatment has so far suggested that it may:

  • reduce symptoms of depression
  • reduce symptoms of anxiety – reduce the intensity of intrusive traumatic thoughts – help to reduce social anxiety by reducing avoidance behaviors
  • improve cognitive control
  • reduce impulsivity
  • reduce suicidality

POSSIBLE SIDE EFFECTS OF TMS :

Unfortunately, TMS cannot be administered to those individuals who have been fitted with a pacemaker (or, for that matter, have had any other metal implanted in their body). Also, it cannot be administered to those who suffer from epilepsy in most cases.

In rare cases, TMS may induce seizures or manic episodes.

BORDERLINE PERSONALITY DISORDER AND TMS:

According to a systematic review of the relevant literature (published in Psychiatric Research) by Konstantinou and his colleagues (University of Toronto), the effect that TMS has on the brain’s circuitry related to symptoms of BPD means it might be a viable treatment option for those suffering from the condition in the future. especially as, in such patients, the treatment appears to be well tolerated. According to the researchers, although it is too early to draw any definite conclusions, TMS may be particularly useful for helping BPD sufferers to control their emotions and reduce their tendency toward impulsivity.

The researchers also point out that further research needs to be carried out to help elucidate which brain areas of BPD sufferers should be targeted by the treatment for optimum results given the patient’s pattern of symptoms. They also state that TMS may be most useful when used in conjunction with evidence-based psychotherapy.

NB Anyone considering the treatment should discuss it with their doctor or other suitably qualified medical professional.

 

Improved Transcranial Magnetic Stimulation Procedure: Stanford Neuromodulation Therapy

(This section was added on 1st July 2022 as part of the general updating of this site.)

A new type of repetitive transcranial magnetic stimulation (rTMS) called “Stanford neuromodulation therapy’’ adds imaging technology to the treatment, allows it to be more personalized, and increases the dose of rTMS has been developed by scientists and it appears to work more than eight times faster than the current approved treatment.

 

Like in the earlier version of TMS, a coil is placed on top of the head and creates a magnetic field that sends electric pulses through the skull to stimulate the surface of her brain. In cases of severe depression, the electrical current can be directed at the prefrontal cortex, which is the part of the brain that plans, make decisions, and helps us to be rational and logical. It is theorized to be underactive in those suffering from depression. The effect of the stimulation helps increase its activity and maintain that increase in activity. This also has a knock-on effect of reducing activity in the limbic system which, in turn, reduces feelings of fear and anxiety. And it works faster than the standard treatment that preceded it. Indeed, a recent study showed that extremely encouraging results can be attained in 5 or fewer days. Furthermore, almost 80% of patients given the treatment entered remission and became free of symptoms within a month (compared to 13% who received placebo treatment). No serious side effects were reported, though some reported a ‘slight headache.’ 

Encouragingly, too, the treatment was found to be effective for many who had resistant depression that had not responded to other more established treatments. 

Unusually, too, the outcome of the study was so statistically convincing that, though it had initially been planned to test the effectiveness of this new kind of transcranial magnetic stimulation treatment on a much larger sample, this was rendered unnecessary.