Deep transcranial magnetic stimulation — or deep TMS therapy — is an innovative mental health treatment technique using exciting new technologies and methods.
Recent scientific investigations have determined that deep TMS therapy is an evidence-based treatment method that can be used for many mental health conditions. In addition, the practical applications of deep TMS continue to grow.
But before you start deep TMS therapy, you’ll likely want to know what to expect. This guide will cover the fundamental science of deep TMS, how it treats common mental health concerns, and what the treatment process looks like when you begin.
What Is Deep TMS Therapy?
Deep TMS therapy is a novel mental health treatment that sends targeted magnetic impulses deep into the brain. For many mental health conditions associated with deficits in certain brain functions, this can rapidly and durably improve mental health symptoms.
The history of deep TMS therapy spans decades of scientific work. The beginnings can be traced back to electroshock therapy. At the time, it was a controversial, painful, and untargeted method of stimulating neuronal activity, which nonetheless was an effective treatment. It is now a humane, well-studied treatment called electroconvulsive therapy.
Deep TMS is a separate approach that is the culmination of efforts to localize archaic electroshock therapy, remove discomfort, and intervene with more precision and compassion.
In its current state, deep TMS is completely non-invasive, highly safe, and produces minimal discomfort. It has received FDA approval for a number of different mental health conditions and is used as an off-label treatment for countless more.
How Deep TMS Therapy Works
Understanding how deep TMS therapy works requires a brief understanding of the brain and certain mental health conditions. Unlike many other styles of mental health intervention, deep TMS works on the brain directly, so understanding the function and effect of deep TMS relies on a fundamental understanding of brain function.
A Brief Primer on the Brain
The human brain is often referred to as the most complex structure in the known universe. Scientists estimate that there are approximately 100 billion neurons, or brain cells, in the average mature human brain. Each of these neurons can create more than a thousand connections with other neurons, totaling over 100 trillion synaptic connections.
The connections between brain cells are both chemical and electrical in nature. Small electrical signals sent between neurons cause the release of certain chemicals, known as neurotransmitters, to be passed between neurons. This includes neurotransmitters such as:
- Dopamine: The “reward” neurotransmitter
- Serotonin: The “mood” neurotransmitter
- Adrenaline: The “fight or flight” neurotransmitter
- GABA: The “calming” neurotransmitter
- Acetylcholine: The “learning” neurotransmitter
- Glutamate: The “memory” neurotransmitter
- Endorphins: The “euphoria” neurotransmitter
- Noradrenaline: The “concentration” neurotransmitter
When the right amount of electricity reaches a certain neuron, it causes a release of these neurotransmitters down a chain of connected neurons. This is our current, fundamental understanding of what causes us to think, feel, and behave in certain ways.
Another key component to understanding brain function is that neurons that regularly send signals to each other build stronger connections, and those that rarely communicate get pruned away. “What fires together, wires together” is a common quote used by neuroscientists to describe this phenomenon.
Of course, this is a highly condensed understanding of the brain’s function and activity. There are hundreds of different factors at play that scientists know of and countless more that aren’t understood. It is likely that many simply haven’t been discovered quite yet.
Understanding Common Mental Health Conditions
The next step is understanding how electrical and chemical signaling is often hindered by the mechanisms underlying common mental health diagnoses. Using advanced brain-imaging techniques, scientists have discovered that many mental health disorders are associated with a reduction of activity in certain brain regions.
For example, in studies investigating major depressive disorder, imaging reports have shown a reduction of activity in several different brain regions, including the prefrontal cortex, the limbic system, and the basal ganglia, when compared to neurotypical controls.
Countless other investigations have found similar reductions in brain activity for mental health disorders, such as:
- Anxiety disorders
- Obsessive-compulsive disorders
- Post-traumatic stress disorder
- Bipolar disorder
The majority of these imaging studies use a technique known as magnetic resonance imaging (MRI). An MRI doesn’t detect electrical or chemical activity within the brain directly but rather provides a detailed map of where blood travels within the brain.
Regions with more blood flow are typically more electrically and chemically active, while regions with low electrical and chemical activity need less blood supply. The reasoning follows that low levels of blood flow mean reduced electrical activity, which in turn leads to reduced transmission of essential neurotransmitters.
Furthermore, scientists have shown that people who achieve recovery from a mental health condition will typically restore brain functioning in these areas. Restoring the activity to these brain regions is thus associated with the mental health outcomes that people hope for.
Using conventional treatments like talk therapy, although still an effective standard of care, can take a long time for people to achieve this goal.
How Deep TMS Supports Recovery
Deep TMS takes these findings from neuroscience and puts them into practical application. Since we know that many mental health conditions lead to reduced electrical activity within the brain, deep TMS therapy aims to intervene directly by enhancing electrical activity in these areas.
And since “what fires together wires together,” the brief impulses provided by deep TMS can create lasting changes in electrical activity, even well after you’ve completed the treatment process itself. This leads to improvements in brain functioning, better-regulated neurotransmission, and tangible symptom relief.
Of course, there are several other ways to create these changes. The same improvements can be achieved through interventions such as:
- Individual therapy
- Psychiatric medication
- Lifestyle changes
However, all of these approaches are indirect and often prove ineffective for people with many common mental health challenges.
How Deep TMS Therapy Works
Deep TMS therapy uses specialized technology to help people achieve these incredible results. On a surface level, the device used in deep TMS resembles a padded helmet attached to a large electronic device. But contained within this helmet are powerful electromagnets designed specifically to create electrical impulses deep within the brain.
By using specially designed electromagnetic coils, a small electrical impulse can be created in targeted brain regions. Different coils are used to target separate brain regions, and your deep TMS provider will determine which coil provides the targeted care for your exact needs.
At Plus by APN, we use three different patented helmet options by BrainsWay, each with different electromagnetic coils, to treat a wide variety of mental health conditions. Electrical impulses from these helmets are typically sent to regions of the brain that are directly influenced by common mental health disorders. For example:
- H1 Coil: Stimulates the bilateral prefrontal cortex and is used in the treatment of depression and anxious depression
- H4 Coil: Stimulates the prefrontal cortex as well as the bilateral insula and is commonly used in the treatment of smoking addiction
- H7 Coil: Stimulates the medial prefrontal cortex and the anterior cingulate cortex and is used to treat OCD, major depressive disorder, and anxious depression
The magnetic impulse from these coils can kickstart the electrical activity of underactive brain regions. This can lead to rapid symptom relief and long-lasting results.
Who Deep TMS Therapy Can Benefit
At Plus by APN, we use deep TMS therapy to treat a wide range of mental health conditions. This includes both FDA-approved treatments and off-label treatment options that are guided by current and ever-evolving research into this exciting treatment modality.
The current FDA-approved treatment options using deep TMS therapy include:
- Smoking addiction
- Major depressive disorder
- Obsessive-compulsive disorder
- Anxious depression
An abundance of research has shown that these treatments are safe, effective, and produce lasting results for these conditions. Significant research has shown that deep TMS is often highly effective for people experiencing “treatment-resistant” mental health challenges, meaning they have tried conventional therapies before without success.
However, the research supporting deep TMS extends far beyond these four conditions alone. At Plus by APN, we also provide deep TMS treatment for conditions such as:
- Autism spectrum disorder
- Bipolar disorder
- Anxiety disorders
- Post-traumatic stress disorder
- Chronic pain
- Multiple sclerosis
- Post-stroke rehabilitation
These treatments are considered off-label in the United States, meaning they have not yet received FDA approval. Importantly, this does not mean that they are ineffective; it only means that they have not yet gone through the lengthy and expensive process of approval.
Off-label treatments are a common and legal form of healthcare in the United States. It’s estimated that one in five prescriptions are for off-label use. While we are hopeful that deep TMS will achieve FDA approval for these conditions in the near future, we won’t withhold potentially life-transforming treatment options to informed clients in the meantime.
The Deep TMS Process
The process of deep TMS therapy is relatively simple. It starts with a brief call with one of our care team members, who can answer any initial questions and set you up for your first appointments.
Next comes a detailed evaluation process, which can help our team determine whether deep TMS therapy is right for you. This includes determining what your specific mental health condition is, whether you’ve tried other treatment methods in the past, and if you have any co-occurring medical conditions that could disqualify you from this treatment option.
The treatment itself is typically very brief. After placing a small cap on your head and the deep TMS helmet over that, you only need to sit in a comfortable chair for the treatment session. A typical session lasts 20 to 30 minutes while our team monitors and controls the deep TMS machine delivering treatment.
During your session, you’ll hear the machine making a repetitive tapping or clicking noise. This is from the electromagnetic coils, sending small bursts of activity into targeted brain regions.
After the session is completed, you’re free to go about your everyday life. There is no downtime, no invasive procedures, and no need to reschedule important appointments.
To achieve the best results, most people need several sessions. The exact number of sessions depends on each person’s need, but 30-36 sessions are common to get optimal results from treatment.
Get Started at Plus by APN
Plus by APN is dedicated to bringing the best in innovative technologies and treatment methods to our clientele, as well as excellence in more traditional treatment approaches.
To learn more about deep TMS therapy at Plus by APN or to hear more about our comprehensive mental health treatment options, call our team today at 424.644.6486, use the live chat function on our website to speak to one of our representatives, or fill out our confidential online contact form for more information.
References
- Aron Tendler, Noam Barnea Ygael, Yiftach Roth & Abraham Zangen (2016) Deep transcranial magnetic stimulation (dTMS) – beyond depression, Expert Review of Medical Devices, 13:10, 987-1000, DOI: 10.1080/17434440.2016.1233812
- Bersani FS;Minichino A;Enticott PG;Mazzarini L;Khan N;Antonacci G;Raccah RN;Salviati M;Delle Chiaie R;Bersani G;Fitzgerald PB;Biondi M; “Deep Transcranial Magnetic Stimulation as a Treatment for Psychiatric Disorders: A Comprehensive Review.” European Psychiatry : The Journal of the Association of European Psychiatrists, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/22559998/. Accessed 15 May 2024.
- “FDA Permits Marketing of Transcranial Magnetic Stimulation for Treatment of Obsessive Compulsive Disorder.” U.S. Food and Drug Administration, FDA, www.fda.gov/news-events/press-announcements/fda-permits-marketing-transcranial-magnetic-stimulation-treatment-obsessive-compulsive-disorder. Accessed 15 May 2024.
- Gulati, Anil. “Understanding neurogenesis in the adult human brain.” Indian journal of pharmacology vol. 47,6 (2015): 583-4. doi:10.4103/0253-7613.169598