ORANGE COUNTY TMS QUESTIONS

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:

• Anxiety disorders, such as OCD
• Post-Traumatic Stress Disorder (PTSD)
• Schizophrenia
• Parkinson's Disease
• Alzheimer's Disease
• Dementia
• Nicotine Addiction
• Autism Disorders

Other uses outside of Psychiatry may include:

• Stroke Rehabilitation
• Chronic Pain
• Tinnitus
• Fibromyalgia
• Tourette Syndrome
• Multiple Sclerosis

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:

• 50% - Mild headaches, which tend to go away throughout treatment.
• 30% - Facial twitching with TMS pulses.
• Short-term hearing problems  (Earplugs help eliminate this).

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:

• Metal in their head (plates)
• Aneuryms clips/coils
• Neck or brain stents
• Stimulators placed deep in the brain
• Electrodes which measure brain activity
• Metal implants in eyes or ears
• Bullet fragments (Shrapnel) in/near the head
• Tattoos on the face utilizing metallic or magnet sensitive ink

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.