Transcranial Magnetic Stimulation and the Human Brain | Promising Applications and Insights

Transcranial magnetic stimulation (TMS) is a non-invasive technique that uses magnetic fields to stimulate nerve cells in the brain. In this article, we will discuss what TMS is, how it works, and its applications in treating various mental health conditions such as depression and OCD. As you read on, you will clearly understand the science behind transcranial magnetic stimulation and the human brain and its potential benefits.

Key Takeaways

Transcranial magnetic stimulation (TMS) is a non-invasive procedure that uses magnetic pulses to stimulate nerve cells in the brain, offering treatment for various mental health conditions, including depression, OCD, and anxiety.
Different types of TMS, such as repetitive TMS (rTMS), deep TMS (dTMS), and intermittent theta burst stimulation (iTBS), have unique applications and vary in treatment duration and depth of brain stimulation.

What is Transcranial Magnetic Stimulation (TMS)?

Transcranial magnetic stimulation (TMS) is a non-invasive procedure that uses magnetic pulses to stimulate nerve cells in the brain. It is commonly used to treat conditions such as depression, anxiety, bipolar disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), schizophrenia, and chronic pain. TMS does not require surgery or cutting of the skin, making it a preferred option for many individuals seeking treatment for mental health conditions.

At the core of TMS is the principle of electromagnetic induction1. The magnetic pulses administered to specific brain parts create electric fields that can depolarize neurons, influencing their activity. This process, known as repetitive transcranial magnetic stimulation (rTMS), is commonly used for conditions like depression and OCD. In contrast, deep brain stimulation involves direct electrical stimulation of the brain.

TMS encompasses different forms, including deep transcranial magnetic stimulation (dTMS) and intermittent theta burst stimulation (iTBS), each with unique applications and treatment durations. This adaptability allows TMS to effectively address various mental health conditions.

Mechanisms of Action

Transcranial magnetic stimulation (TMS) induces an electric field that can activate neurons that causes changes in neuronal firing rates2. TMS can either excite or inhibit neuronal activity, depending on the frequency and intensity of the magnetic pulses.

Repetitive TMS (rTMS) protocols can bring about long-term changes in neural circuits by modulating synaptic plasticity3. High-frequency TMS can enhance synaptic strength and excitability, similar to long-term potentiation (LTP). These effects can influence broader neural networks beyond the directly stimulated regions, showing the widespread impact of TMS.

TMS can also affect neurotransmitter systems4, such as increasing the release of dopamine, which is important for reward and motivation. The precision of TMS depends on factors like coil design and placement, which determine the specific brain regions affected. In conditions such as depression, the magnetic pulses in TMS are believed to activate brain regions with decreased activity.

Types of TMS

There are different types of TMS, each with unique characteristics and applications.

Repetitive TMS (rTMS) involves delivering repeated magnetic pulses to the brain to stimulate nerve cells. This technique is commonly used for conditions like depression and OCD, where it can activate specific brain regions and modulate neural activity. rTMS represents a significant stride in the development of noninvasive brain stimulation techniques, offering a novel way to treat various mental health conditions.

However, deep TMS (dTMS) differs from rTMS because it uses a coil that stimulates deeper and broader brain areas5. The added depth allows for the stimulation of brain regions that were previously hard to reach with conventional TMS techniques, making it similar to deep brain stimulators in terms of targeting depth.

Meanwhile, intermittent theta burst stimulation (iTBS) is a newer form of TMS that can be completed in as little as 3.5 minutes per session6. It is an exciting addition to the TMS family, providing an efficient alternative for patients and clinicians.

Clinical Applications of TMS

The versatility of TMS extends to its applications in various mental health conditions. Its ability to non-invasively stimulate brain activity has made it a valuable tool in treating conditions like:

Depression
OCD
Migraines
Aiding smoking cessation

Major Depression

Major depressive disorder (MDD) is a widespread mental health condition, and transcranial magnetic stimulation (TMS) has shown significant success in treating it7. This technique uses magnetic fields to activate nerve cells in the brain, which can help reduce symptoms of major depression. Studies have shown that repetitive TMS to the dlPFC can affect both the dlPFC and a network of connected regions, which includes the ACC and nearby medial prefrontal structures8.

TMS is effective as a standard treatment for depression when medications and talk therapy fail. Some key benefits of deep TMS in this area:

Up to 65.3% of depression clients achieve remission with deep TMS9.
The time it takes to see improvements in symptoms with deep TMS varies; up to one in three patients experiences remission by the end of week four9.
TMS is FDA-approved for the treatment of major depressive disorder, especially for patients who have not responded to other treatments10.

These factors make deep TMS a promising option for those struggling with depression.

Obsessive Compulsive Disorder (OCD)

OCD is another condition where TMS has demonstrated promising results. Around 40% of OCD patients do not respond to traditional treatments like psychotherapy and antidepressant medication11, which makes TMS a viable alternative. By targeting and modulating activity in specific brain areas associated with the disorder, TMS can reduce symptoms of OCD.

TMS treatment for OCD involves up to 30 sessions, usually divided into courses of 10 sessions over three to six weeks. Up to 60% of OCD patients achieve response after 29 treatments with deep TMS12. These promising results shine a light on the potential of TMS as an effective treatment for OCD.

Anxious Depression and Smoking Cessation

The potential applications of TMS are not limited to depression and OCD. It is also being explored for its efficacy in treating anxious depression, smoking cessation, and others.

By influencing neural circuits involved in anxiety regulation, TMS potentially offers relief for patients with both anxiety and depression. The ongoing research aims to assess the full potential of TMS in treating anxious depression13.

TMS is also being utilized in smoking cessation treatments. By stimulating areas of the brain associated with addiction, TMS offers a non-pharmacological approach to aiding smoking cessation14. This further underlines the versatility of TMS in mental health treatments.

Is TMS Safe?

While the advantages of TMS are plentiful, discussing its safety and potential side effects is equally significant. Generally, TMS is considered safe and well-tolerated. The most common adverse events reported during rTMS therapy are mild headaches and discomfort at the stimulation site15, which is easily managed with over-the-counter analgesics and adjustments.

Nevertheless, TMS proves to be a safe and effective treatment, and patient safety is always a top priority when administering TMS treatments.

Advances in TMS Research

The field of TMS research is dynamic and ever-evolving, with new findings and advancements contributing to our understanding of this innovative treatment.

We will now investigate some of the recent breakthroughs in TMS research.

Intracranial Electrocorticography (iEEG) Studies

One significant advancement in TMS research involves intracranial electrocorticography (EEG) studies16. Key findings from the study:

TMS using iEEG was found to be safe and well-tolerated.
Neuronal responses were observed in various brain regions, including the motor cortex and prefrontal cortex.

These findings provide valuable insights into TMS research and its clinical applications in various settings. The iEEG method allowed researchers to record the physiological effects of TMS on the human brain, specifically in the cerebral cortex, demonstrating specific neuronal responses in areas like the anterior cingulate cortex and anterior insular cortex. This method of recording data from the human brain provided valuable insights into brain function, neural activity, and the potential impact of treatments like vagus nerve stimulation.

These iEEG studies offer valuable insights into the physiological effects of TMS on the human brain, helping to refine its application and improve its effectiveness.

Network-Level Brain Responses

Another exciting development in TMS research is the discovery of its network-level effects on the brain. TMS influences neuronal activity and modulates brain function through network-level effects that preferentially modulate sites connected to the stimulation site17. TMS to the dlPFC induces network-level brain responses in the ACC and insular cortex, regions functionally connected to the stimulation site.

Regional patterns of significant iTEPs were observed following TMS targeting the left dorsolateral prefrontal cortex (dlPFC)18. Such findings underscore the far-reaching impact of TMS, highlighting its ability to influence network-level brain responses and stimulate functionally connected sites.

Get Personalized Mental Health Treatment at Plus by APN

At Plus by APN, we understand that a mental health treatment plan is not a one-size-fits-all approach. Each patient is unique, and so is their treatment plan. We customize mental health plans based on an individual’s story and the latest scientific research.

Our clinic uses brain mapping and qEEG to understand your brain’s activity and tailor treatment plans. This data-driven approach allows us to personalize treatments and make them more effective. Our treatments include deep TMS, ketamine therapy, hyperbaric oxygen therapy, and more.

When you choose Plus by APN for TMS, you receive a comprehensive review to ensure treatments align with your personal history and goals. Treatment plans are continually tracked and adjusted based on progress. This commitment to personalized, evidence-based treatment is a cornerstone of Plus by APN’s approach to mental health care.

We have several locations across the United States and the UK, including Boulder, Denver, and Edwards, Colorado; Dallas-Fort Worth, Texas; and Malibu, Florida in the US; and London in the UK.

At Plus by APN, we offer physical locations as well as digital telehealth options, allowing for remote therapy sessions. Schedule your consultation today to get started.

Frequently Asked Questions

What is transcranial magnetic stimulation (TMS)?

Transcranial magnetic stimulation (TMS) is a non-invasive procedure that uses magnetic pulses to stimulate nerve cells in the brain, and it is commonly used to alleviate symptoms of mental health conditions such as depression and obsessive-compulsive disorder.

What are the different types of TMS?

The three main types of TMS are repetitive TMS (rTMS), deep TMS (dTMS), and intermittent theta burst stimulation (iTBS), each with its own applications and treatment durations.

What is the approach of Plus by APN to mental health?

At Plus by APN, we take a comprehensive approach to mental health, combining interventional psychiatry with modern healthcare techniques to provide personalized treatment plans based on individual needs and scientific insights. This approach addresses mental health concerns with a tailored and evidence-based strategy.

Final Thoughts

Transcranial magnetic stimulation (TMS) shows promise as a noninvasive and effective treatment for various mental health conditions. By stimulating neural activity and modulating brain function, TMS has demonstrated significant success in treating conditions such as depression and OCD. Ongoing research and advancements in TMS underscore its potential and the exciting possibilities for future applications.

At Plus by APN, we are at the forefront of this exciting field, offering deep TMS treatments as part of a comprehensive and personalized approach to mental health care. Our commitment to evidence-based treatment and patient-centered care sets us apart. Contact us to schedule your consultation today.