Transcranial magnetic stimulation (TMS) is a noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. TMS is typically used when other treatments haven't been effective or if a patient is seeking an alternative form of treatment.
Psychiatrists often diagnose symptoms and treat patients with medication and psychotherapy. An alternative treatment is TMS. TMS may be used to treat:
Other uses outside of Psychiatry may include:
Medication and Psychotherapy are often the first steps a psychiatrist uses in treating a patient. However, a psychiatrist may suggest TMS upon a full evaluation and usually after several sessions. Some patients may have years of medication use and ask to try something different.
TMS changes neuronal activity in parts of the brain which involve mood regulation (prefrontal cortex). A magnetic pulse goes through the skull (into the brain), which induces activity of brain cells. Activity may be increased or decreased. Stimulating one side versus another side would have an opposite effect in regulation of moods.
Patients are asked to remove jewelry or magnetic-sensitive items and may be given earplugs (the machine makes clicking sounds similar to an MRI machine).
The first session takes multiple measurements to make sure the TMS coil is placed in the correct location. The TMS coil is then attached to the patients forehead. Brief pulses are used to motor threshold (the minimum power to cause a patient's thumb to twitch.
The session begins with clicking sounds and a "tapping sensation" under the TMS coil. The patient is closely monitored and adjustments may be made as the patient progresses.
TMS sessions are only prescribed by a psychiatrist or medical provider with extensive use of TMS. A technician may perform TMS treatment under the direct supervision of a psychiatrist.
The initial session may take up to an hour. Follow up sessions are usually 30-40 minutes and may be done 1-5 days per week. TMS treatment usually lasts for 4-6 weeks.
No, TMS treatments do not require anesthesia, you will be awake and aware of the process. Patients do not need recovery time - you are safe to continue your normal routine afterwards.
Patients reported side effects of TMS may include:
No medication side-effects reported, such as an upset stomach, sexual dysfunction, weight changes, or sleepiness. A technician is in the room and available to make sure you are comfortable and can adjust the TMS coil, as needed.
We do not utilize TMS on patients who have:
The use of magnets to treat mental health patients has been utilized for over 100 years, TMS itself was developed in the 1980s. The FDA approves the technique for treating multiple disorders and mental health symptoms.
Dr. Alva and the team of medical professionals at PNS have utilized TMS for more than 10 years and have utilized TMS on thousands of patients. Our facility is widely regarded as the leading TMS treatment provider in Orange County, CA. NeuroStar machines have treated over 2.5 million patients.
Vagus nerve stimulation (VNS) is a surgical procedure that can be used to treat those with treatment-resistant depression. A pacemaker-like device, implanted in the body, is attached to a stimulating wire that is threaded along a nerve called the vagus nerve. The vagus nerve travels up the neck to the brain, where it connects to areas believed to be involved in regulating mood. Once implanted, this device delivers regular electrical impulses to the vagus nerve.
Transcranial magnetic stimulation (TMS), also known as repetitive transcranial magnetic stimulation (rTMS), is a noninvasive form of brain stimulation in which a changing magnetic field is used to cause electric current at a specific area of the brain through electromagnetic induction. An electric pulse generator, or stimulator, is connected to a magnetic coil, which in turn is connected to the scalp. The stimulator generates a changing electric current within the coil which induces a magnetic field; this field then causes a second inductance of inverted electric charge within the brain itself.
Deep brain stimulation has been a U.S. Food and Drug Administration-approved therapy to help patients with essential tremor since 1997, Parkinson’s disease since 2002, and dystonia since 2003. Tens of thousands of patients with these movement disorders have undergone the procedure, which places electrodes deep in the brain and, in follow-on surgeries, implants batteries to supply an adjustable amount of electrical stimulation to those electrodes.
In 2009, the FDA approved deep brain stimulation for obsessive-compulsive disorder (OCD) that’s severe to extreme, which isn’t a movement disorder. The approval hinged on an FDA Humanitarian Device exemption, which applies to treatments for diseases rare enough that it’s difficult to impossible to enroll enough patients to run effective clinical trials. While OCD diagnoses are common – about one in 40 people will experience it at some point – its severest forms are rare. The exemption – rather than full FDA approval – has led to high hurdles for deep brain stimulation for OCD patients.
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