Repetitive transcranial magnetic stimulation (rTMS) is a breakthrough treatment that is offering hope to those facing challenging health conditions. In this guide, we’ll break down what rTMS is, how it works, who it can help, and what you can expect from treatment.
What is Repetitive Transcranial Magnetic Stimulation?
Repetitive transcranial magnetic stimulation is a safe and non-invasive treatment that helps relieve symptoms in individuals diagnosed with psychiatric and neurological disorders. It works by delivering recurring magnetic pulses to brain regions responsible for mood and behavior in order to modulate or adjust their activity levels. In other words, rTMS helps “reset” areas of the brain that are overactive or underperforming.
What Conditions Can rTMS Treat?
rTMS is FDA-approved for treating several conditions that may not respond to traditional treatments. These include:
- Treatment-resistant depression
- Obsessive-compulsive disorder (OCD)
- Migraines
- Anxiety with depression
- Smoking cessation
Although these are the only disorders approved by the FDA, researchers are continuing to study rTMS for other conditions, such as chronic pain, insomnia, and bipolar disorder.
Does rTMS Have Side Effects?
rTMS is generally considered safe and tolerable; however, some individuals may experience mild and temporary side effects. These may include:
- Discomfort at the application site
- Muscle contractions
- Tingling in the scalp, jaw, or face
- Mild headaches
- Lightheadedness
- Dizziness
Seizures are rare but possible. Strict safety protocols and patient screenings can help reduce this risk.
How rTMS Affects the Brain
One of the effects of rTMS is that it improves neuroplasticity, which is the brain’s ability to adapt and reorganize by forming new connections between neurons. This is important for recovery, learning, and improving brain function. High-frequency rTMS (5 Hz or more) increases neuron activity and excitability, whereas low-frequency rTMS (less than 1 Hz) reduces excitability, thus calming overactive brain areas.
rTMS also changes how different areas of the brain communicate with each other by changing functional connectivity. This means it can adjust how brain regions that are involved in motor, emotional, and cognitive processes work together. For example, rTMS can balance activity within the Default Mode Network (DMN), which is often disrupted in conditions like depression.
Additionally, rTMS influences neurotransmitters such as glutamate, dopamine, and GABA, all of which affect mood, cognition, and motor control. Increased levels of GABA are a result of the calming effects of low-frequency rTMS, while changes in glutamate and dopamine can improve mood and motivation.
Who Can rTMS Benefit?
If you’ve been struggling with symptoms and feel like you’re out of options, rTMS might be an alternate consideration. This treatment can be beneficial for those dealing with:
- Treatment-resistant depression
- Side effects from medications that are hard to manage
- Conditions where other therapies haven’t worked
Who Should Avoid rTMS?
While rTMS is safe for most people, there are some cases where it’s not the right choice. You should avoid rTMS if you have:
- Implanted electronic devices in your body (e.g., pacemakers)
- Magnetic metal plates or implants in or around your head
- A history of seizures or a medical condition that makes seizures more likely to occur
If you’re pregnant or nursing, rTMS might still be an option in severe cases, but it needs careful consideration and guidance from a doctor. Taking these precautions helps to ensure that rTMS is both effective and safe for the people who need it most.
Benefits of Repetitive Transcranial Magnetic Stimulation
rTMS comes with several advantages that make it an appealing option for those seeking alternative treatments. Here are some of the benefits:
- Mild side effects that don’t interfere with your day
- No need for sedation of anesthesia
- No downtime, so you can get back to your routine right away
- Faster symptom relief compared to medications
- Encourages brain cells to work together to help the brain function better
- Boosted cognitive skills like memory, focus, and language in those with mild cognitive impairment
Research That Proves TMS Success
The effectiveness of rTMS has been backed by numerous studies and has shown improvements in symptoms across several conditions. Below are some findings from recent research:
- A study at UCLA Health reviewed outcomes from 2009 to 2022 and found that 54% of patients treated with rTMS showed at least a 50% improvement in mood symptoms based on multiple depression rating scales.
- Research on smoking cessation found that rTMS helps reduce delay discounting, which is where smokers choose immediate satisfaction over the long-term benefits of quitting.
- Longer and more intense rTMS sessions led to stronger reductions in delay discounting and improved smoking abstinence rates.
- A study on migraines showed that rTMS was more effective than placebo for decreasing the frequency of migraine attacks. This was especially evident when the dorsolateral prefrontal cortex was stimulated.
- Another study found that patients with both OCD and depression experienced significant improvements in OCD symptoms when their depression symptoms improved with rTMS.
- Patients with OCD who received rTMS were three times more likely to respond to treatment compared to placebo groups.
Frequently Asked Questions About rTMS
rTMS is gaining more attention as an alternative treatment for certain conditions due to its effectiveness and growing accessibility. Below are answers to some of the most commonly asked questions about this therapy.
How Much Does rTMS Cost?
The cost of rTMS can vary depending on the clinic and treatment plan, but a course of 20 to 30 sessions typically costs between $6,000 and $12,000. While this may seem expensive compared to antidepressant treatment, studies have shown that rTMS is more cost-effective for patients with depression who haven’t benefited from medication. As newer devices receive FDA approval, the overall cost of rTMS therapy might change.
Does Insurance Cover rTMS?
Yes, most major insurance companies cover rTMS, but coverage criteria can differ and can sometimes be difficult. For example, some insurers will cover rTMS for patients with moderate symptoms, while others might require more severe symptoms to approve treatment. Insurance providers also use different depression rating scales to determine eligibility. It’s important to work closely with your healthcare provider and insurance company so you understand the requirements that need to be met for treatment approval.
What Are The Long-Term Results?
Research suggests that maintenance rTMS can help prevent relapse in treatment-resistant conditions, especially during the first six months following acute treatment. Protocols that taper sessions over time seem to be effective in addressing the high relapse rates that are often seen.
What Should You Expect During a Session?
An rTMS session is straightforward and non-invasive. A magnetic coil is placed on your head to deliver targeted pulses, and you remain awake and seated during the treatment. Sessions typically last 20 to 40 minutes, and most people can return to their regular activities immediately afterward. While some may feel mild scalp discomfort, side effects should not interfere with your day.
Learn How rTMS Can Help You
If you’ve been searching for a new way to deal with your symptoms, rTMS might be the answer. From depression to OCD to migraines, this non-invasive treatment provides real results with minimal side effects. It’s also backed by research and has shown promise for those who haven’t had success with traditional treatments.
Ready to see if rTMS is right for you? Reach out today to learn more. We’re here to help you feel like yourself again.
Sources:
- Repetitive Transcranial Magnetic Stimulation – StatPearls
- Brain Stimulation Therapies – National Institute of Mental Health
- Effects of repetitive transcranial magnetic stimulation and their underlying neural mechanisms evaluated with magnetic resonance imaging-based brain connectivity network analyses – European journal of radiology open
- Safety and recommendations for TMS use in healthy subjects and patient populations, with updates on training, ethical and regulatory issues: Expert Guidelines – Clinical Neurophysiology
- Study finds possible early predictor of successful transcranial magnetic stimulation therapy for major depression – UCLA Health
- Repetitive transcranial magnetic stimulation (rTMS) triggers dose-dependent homeostatic rewiring in recurrent neuronal networks – bioRxiv
- A Systematic Review and Meta-Analysis of Cognitive Effects of rTMS in Caucasian Patients with Mild Cognitive Impairment – Brain Sciences
- Transcranial Magnetic Stimulation for Long-Term Smoking Cessation: Preliminary Examination of Delay Discounting as a Therapeutic Target and the Effects of Intensity and Duration – Frontiers in Human Neuroscience
- Efficacy of repetitive transcranial magnetic stimulation on chronic migraine: A meta-analysis – Frontiers in Neurology
- A Meta-analysis of Transcranial Magnetic Stimulation in Obsessive-Compulsive Disorder – Biological Psychiatry: Cognitive Neuroscience and Neuroimaging
- Consensus Recommendations for the Clinical Application of Repetitive Transcranial Magnetic Stimulation (rTMS) in the Treatment of Depression – Journal of Clinical Psychiatry
- Guidance on Navigating Insurance Plans for TMS-Eligible Patients – Psychiatric News
- Maintenance repetitive transcranial magnetic stimulation (rTMS) therapy for treatment-resistant depression: a study protocol of a multisite, prospective, non-randomized longitudinal study – BMC Psychiatry
