If you’re struggling with depression or other mental health condition that hasn’t responded to medication and/or therapy, transcranial magnetic stimulation (TMS) might be an option your doctor has mentioned. There are different types of TMS therapy, including deep TMS (dTMS) and traditional TMS, but what’s the difference and how do you choose the treatment that’s right for you?
Here’s a complete breakdown of deep TMS vs. traditional TMS, so you can make an informed decision about your mental health care.
TMS is a non-invasive procedure that uses magnetic fields to stimulate specific areas of the brain that might not be functioning as they should. This procedure doesn’t require surgery or anesthesia, and there are no direct electrical shocks to your brain, like in other brain stimulations such as electroconvulsive therapy (ECT).
Here’s how it works:
During a session, you’ll sit comfortably in a chair with a head rest while your doctor positions the magnetic coil over your head. They’ll then program the device with pulse patterns that fit within your treatment plan.
Most patients describe the sensation as a tapping feeling on the scalp or mild tingly, whereas others might experience slight muscle twitches in the face or scalp. However, these sensations usually stop once the stimulation ends.
Each session lasts about 20-40 minutes, depending on your treatment plan. You also remain fully awake and alert through the session and can resume normal activities immediately afterward.
Since 2008, TMS therapy has gotten FDA approval for several conditions:
Despite the current approvals above, many clinicians offer TMS as an “off-label” treatment for other conditions, including:
Research continues to explore TMS treatment for these conditions, as well as for others, like substance use disorders, chronic pain, and cognitive impairment.
TMS therapy stands out for its favorable safety profile, especially when compared to other treatments that can cause uncomfortable side effects, including weight gain, sexual dysfunction, or sleep disturbances. Benefits of TMS include:
While TMS has several benefits, it’s not without its’ risks:
The risks associated with TMS therapy are generally low, and patients are carefully monitored throughout their treatment course. Before starting TMS, you’ll undergo a thorough evaluation to ensure you’re a good candidate for the procedure. Your provider will explain all potential risks and benefits for your situation and answer any questions you may have.
Traditional TMS and deep TMS are both effective in treating various conditions, but they differ in their approaches in several ways. Here’s how they compare.
Traditional TMS, also known as repetitive TMS (rTMS), delivers repeated magnetic pulses to the brain using a figure-8 shaped coil. The figure-8 coil design creates an electromagnetic field that reaches approximately 1-3 centimeters beneath the skull’s surface. This allows it to target superficial brain regions, including the dorsolateral prefrontal cortex, which is responsible for executive functions and cognitive processing. However, traditional TMS has limitations in terms of how deep into the brain it can go, leading to the development of deep TMS.
Deep TMS has all of the benefits of regular TMS, but it can go slightly deeper into the brain. It uses an H-coil design that can stimulate brain tissue up to 4 centimeters beneath the skull’s surface without increasing the intensity of the stimulation. This allows dTMS to target not only superficial regions but also deeper structures such as the subgenual anterior cingulate cortex, which contains important reward and motivation pathways.
Deep TMS treatment sessions are typically shorter compared to traditional TMS, lasting around 20 minutes. Each session then delivers around 1,980 pulses at a higher frequency. Aside from these differences, the preparation and evaluation processes for dTMS are the same in which a patient is thoroughly evaluated before treatment begins.
Several clinical studies have compared the effectiveness of dTMS and regular TMS for treatment depression. In a randomized-controlled, single-blind trial, 228 patients with MDD were divided into three groups: those receiving dTMS (H1-coil), those receiving traditional TMS (figure-8 coil), and a control group receiving medication therapy alone. Here’s what researchers found:
This study shows that while both TMS treatments were more effective than medication alone, dTMS produced statistically superior response rates and greater reduction in depression severity compared to traditional TMS.
Another multi-center study compared the two types of TMS and found similar patterns:
These clinical outcomes suggest that dTMS may be more effective in treating depression, potentially due to its ability to target deeper brain structures. That being said, both forms of TMS demonstrated their effectiveness above the placebo and control groups, thus confirming that TMS in general is a viable option for patients who haven’t responded to traditional treatments.
When deciding between dTMS and traditional TMS treatment, you should consider a few different factors. Below is a side-by-side comparison to help guide your decision:
Deep TMS | Traditional TMS | |
Effectiveness | Higher response and remission rates | Effective but somewhat lower rates |
Session Duration | Shorter (~20 minutes) | Longer (~40 minutes) |
Brain Targets | Up to 4 cm depth | 1-3 cm depth |
Side Effects | May be more likely to experience mild effects | Similar profile, possibly lower rates of side effects |
Insurance Coverage | Covered by many insurers for approved conditions | Covered by many insurers for approved conditions |
Both types of TMS are FDA-approved, evidence-based treatments with demonstrated effectiveness for depression and other conditions. Your provider can help you weigh the potential benefits and limitations of each treatment so you can choose the one that works best for you and your needs.
At Cura Behavioral Health, we offer TMS therapy that is administered by experienced providers who specialize in treatment-resistant depression and other conditions. We understand that seeking treatment requires courage, and we’re committed to providing compassionate care in a comfortable and supportive environment. Our clinic uses state-of-the-art equipment and follows evidence-based protocols to ensure you receive the highest quality treatment.
If you’re ready to take the next step in your mental health journey, contact our team today to set up a consultation. We’re here to answer your questions and help you through the treatment process with expertise and understanding.
Determining if TMS therapy suits your mental health journey should involve consultation with a qualified professional. At Cura Behavioral Health, we provide comprehensive assessments to help you make informed treatment decisions.
Don’t let a mental health condition hold you back any longer. Schedule a consultation with Cura Behavioral Health today. Our experienced team is ready to answer your questions and create a personalized treatment plan tailored to your unique needs.
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Dr. Kevin Simonson, an esteemed Medical Director at Cura Behavioral Health, brings over 15 years of experience in psychiatry. A graduate from a top medical school, he specializes in the treatment of mood disorders and anxiety, employing a patient-centered approach. His dedication to evidence-based care and his commitment to advancing mental health practices have made him a respected figure in the field. Dr. Simonson’s leadership ensures the highest standard of care for the community at Cura Behavioral Health.
