TRANSCRANIAL MAGNETIC STIMULATION

Transcranial magnetic stimulation (TMS) uses a magnetic coil to deliver brief, focused magnetic pulses, similar in strength to an MRI, to specific areas of the brain. The coil is placed over the area being targeted, and the pulses gently stimulate nerve cells in that area. TMS is FDA-cleared for certain conditions, including depression that hasn’t responded to medication, and it has been studied for supporting brain function in a range of other conditions.

At our clinic, TMS is provided by our psychiatric mental health nurse practitioner, who will evaluate whether it may be appropriate for you. When it is a good fit, TMS can be part of an integrated program, combined with exercises that target the same brain areas identified through your testing. This combination is designed to support function and endurance in those areas. TMS is an important part of many of our NeuroRescue Programs, and results vary from person to person.

TMS uses an electromagnetic coil placed over the specific area of the brain your provider has chosen to stimulate. The coil creates a concentrated magnetic field that is switched on and off rapidly. The magnetic field reaches about 2 to 3 centimeters into the brain directly beneath the coil. As it passes into the brain, it creates very small electrical currents in the outer layer of the brain, called the cerebral cortex. These currents stimulate nerve cells, which then release neurotransmitters and stimulate other nerve cells. With repeated sessions, TMS is thought to help build nerve cell endurance and strengthen connections with other cells and pathways. TMS can change how active nerve cells are and how easily the brain responds to stimulation.

TMS was first cleared by the FDA for treating depression, by stimulating an area called the left dorsolateral prefrontal cortex (DLPFC). The DLPFC plays an important role in mood regulation, and repeated TMS to this area has been shown to help many people with depression that hasn’t responded to medication. TMS isn’t limited to depression. It has also been studied for a variety of neurological conditions, including:

Mental Health Conditions | Concussions and Traumatic Brain Injuries | Dizziness and Vertigo | Headaches and Migraines | Neurodegenerative Disorders | Chronic Pain | Movement Disorders | Neurodevelopmental Disorders | Dysautonomia | Strokes and Vascular Disorders | Peripheral Nervous System Disorders

Every TMS program begins with a consultation, during which one of our psychiatric providers decides whether TMS is appropriate for you. They will go through an intake to check for anything that could make TMS unsafe for you. They will also give you questionnaires and rating scales that help us measure your symptoms and track your progress through treatment. You will then be taken to a treatment room and seated in a motorized recliner, similar to a dental chair.

You will be given earplugs to wear during the procedure. An electromagnetic coil is placed against your head and switched on and off repeatedly to create magnetic pulses. You will hear a clicking sound and feel a tapping sensation under the coil. The pulses are delivered in short bursts of a few seconds.

Your clinician will first run a series of tests to find your primary motor cortex, an area of the brain that serves as a landmark for locating the other areas we may want to stimulate. They will move the coil over the top of your head, using the pulses to map where your motor cortex is. When they find it, you will notice a slight twitch in the hand on the opposite side. They will then run additional tests to find the right intensity for your treatment.