by Tommy Carreras
If you’ve heard of transcranial magnetic stimulation (TMS), it probably means you’ve been struggling and searching for a real solution to major depressive disorder, anxiety, obsessive-compulsive disorder, or a long history of smoking. Maybe you’ve been on and off medications for years, navigating side effects and ever-changing prescriptions that never seem to actually work.
Whatever you’ve been struggling with, there is hope: deep TMS may be the missing piece in your healing journey. But before you get started, it’s essential to go in prepared!
There are two forms of TMS, and while they feature similar technologies, they are not interchangeable or just mildly different versions meant for different issues. Deep TMS is a far more advanced version of its predecessor, repetitive TMS (rTMS) – and those advancements can make a world of difference for those who need help.
Continue reading to understand the differences between deep TMS and rTMS and what to expect as you search for the right treatment.
What is Transcranial Magnetic Stimulation?
Using magnetic stimulation as a treatment for diseases originated more than 100 years ago with a physicist named Michael Faraday. Still, it was not until 1985 that scientists introduced the first modern Transcranial Magnetic Stimulation device. Anthony Barker and his colleagues hypothesized that they could target specific areas of the brain with an alternating magnetic field generated by a simple coil to easily permeate the skull without harm and release neurotransmitters capable of regulating brain function.
Researchers initially focused their work on treating major depressive disorder. Within the first ten years of experiments, clinical studies, and meta-analyses, it became clear that TMS was as effective as comparable pharmaceutical treatments … and carried a much better safety and side effect profile.
Deep TMS and rTMS: A Shared History
This original form of TMS became known as rTMS, or repetitive TMS, because of the way it works: the brain is repetitively stimulated by magnets transcranially. It’s pretty straightforward!
In the late 2000s, scientists developed a newer version of TMS: they called it deep TMS because of its ability to reach deeper brain structures thanks to an improved coil design.
Early deep TMS devices showed remarkable improvements from their predecessor, rTMS; in Phase III trials, deep TMS proved to be more than twice as effective as rTMS, with a remission rate of 32.6% for those struggling with major depressive disorder. Deep TMS also reduced the average number of treatments from 11-14 with rTMS down to six, cutting treatment length in half.
One of the obvious hallmarks of deep TMS seemed to be its efficacy for those with treatment-resistant depression, sparking hope in cases once considered incompatible with pharmacological interventions. Deep TMS trials were so successful that the FDA quickly approved clinical applications, and medical facilities began to follow suit soon after.
Similarities Between Deep TMS and rTMS
Both rTMS and dTMS are noninvasive forms of therapy that use electromagnetic stimulation to activate specific brain regions. BrainsWay, the leading provider of TMS technology, describes the effects of both deep TMS and rTMS like this:
Repeated over time, [TMS] pulses eventually create a regulatory effect within brain structures found to be associated with a number of mental health conditions, helping normalize their neural activity. This in turn helps reduce the frequency and severity of the condition’s symptoms.
Research on both forms point to TMS’s safety and efficacy. Unlike other treatments like medication (which is more likely to cause systemic side effects such as weight gain, sexual dysfunction, nausea, tremors, dry mouth, diarrhea, headaches, constipation, sweating, sleepiness, and anxiety) and electroconvulsive therapy (which carries the risk of cognitive impairment like memory impairment), both deep TMS and rTMS are well-tolerated and unlinked to any significant physical or neurological side effects.
And both forms of TMS can work with other concurrent therapies to enhance their efficacy. Deep TMS is slightly more effective in treating depression symptoms when paired with medication (67%) compared to rTMS (44%), as noted by a 2019 study.
Key Difference Between Deep TMS and Traditional rTMS
If you’re searching for relief from depression, anxiety, OCD, or smoking addiction, and other treatments or medications have not helped you, deep TMS will be a more effective treatment to pursue than traditional rTMS.
The key differences between dTMS and rTMS are the physical scope of each method’s magnetic activation, their proven levels of effectiveness, and their FDA clearance status. In every category, deep TMS proves to be superior.
Deep TMS Has a Higher Scope of Magnetic Activation
The coil designs used in rTMS and dTMS machines are responsible for the differences in their scope of magnetic activation; traditional rTMS models generate magnetic pulses capable of reaching a depth of 0.7cm deep, versus dTMS models, which can reach a depth of 3.2cm.
BrainsWay describes the impact of a greater magnetic activation:
Deep TMS’s advantage lies in its combined ability to not only directly regulate deeper structures linked to mental health conditions, but also to safely target more of these crucial structures during each session. This is because Deep TMS’s magnetic fields spread over wider areas of the brain, while Traditional rTMS’s fields are activated through a narrower prism, increasing the risk of missing relevant brain structures.
BrainsWay notes: “Putting it simply, Deep TMS’s wider scope of activation reduces the likelihood of targeting issues, thereby increasing its efficiency.”
Deep TMS Is More Effective
Deep TMS’s ability to target and stimulate more brain regions makes it more capable of reaching all the relevant brain structures needed to address different symptoms of specific mental health conditions, thereby increasing its efficiency and overall efficacy.
Even in initial clinical trials, deep TMS’s efficacy levels were around double those of traditional rTMS – deep TMS is simply an updated and upgraded version of the rTMS technology.
Deep TMS is FDA-approved for more than just depression
Traditional rTMS received clearance status for treating major depressive disorder in 2008 – a huge advancement for neuromodulation technology! Deep TMS followed closely behind very quickly after its initial release, receiving that same clearance status in 2013.
Deep TMS continued forward, receiving FDA clearance to treat obsessive-compulsive disorder (OCD) in 2018 and smoking cessation in 2020. To date, deep TMS is the only noninvasive medical device cleared by the FDA as a clinically viable treatment for short-term smoking cessation.
Deep TMS has also received the European CE certification mark for a growing number of mental health conditions, meaning it meets the health, safety, and environmental standards of devices sold within the European Economic Area (EEA).
Those conditions include the following:
- Major depressive disorder (MDD)
- Obsessive-compulsive disorder (OCD)
- Alzheimer’s disease (AD)
- Autism spectrum disorder (ASD)
- Bipolar disorder
- Chronic pain
- Multiple sclerosis (MS)
- Parkinson’s disease
- Post-stroke rehabilitation
- Post-traumatic stress disorder (PTSD)
- Negative symptoms of schizophrenia
- Smoking cessation
BrainsWay is currently pursuing FDA clearance for additional mental health conditions.
How Does Deep TMS Work?
Deep TMS is a form of neurotechnology, a growing category of therapies that can act in conjunction with more traditional forms of treatment like talk therapy and medication. Other “out of the box” treatments might include ketamine-assisted healing, neurofeedback, stellate ganglion blocks (SGB), and hyperbaric oxygen therapy.
All of these forms of neurotechnology help alleviate different intense symptoms associated with mental health conditions, allowing you to not only find relief but also do the hard work of addressing the root causes and environmental factors that may be contributing to your symptoms. Deep TMS can be part of a more well-rounded treatment plan that helps you find your way to healing.
Different Coils for Different Issues
Each easy-to-wear deep TMS helmet houses a different coil designed to target specific conditions. At APN, we have three different types of helmets with uniquely designed coils built to treat depression, anxiety and OCD, and smoking cessation.
An important first step of deep TMS treatment is the initial brain mapping, which lasts longer than average TMS sessions. Brain mapping (sometimes called cortical mapping) involves pinpointing the left dorsolateral prefrontal cortex (DLPFC).
This part of your brain mediates various essential cognitive functions, including short-term memory and emotional responses to people, places, and events. It also lights up with activity when we make risky and moral decisions.
Your deep TMS technician will use the information from your brain mapping session to determine the appropriate levels of stimulation, effectively creating a unique treatment plan designed just for you.
Regular dTMS Sessions
After your first dTMS session, your subsequent appointments will all be very similar! At APN, you’ll take a seat in a comfortable chair, pop on the cushioned TMS helmet, and complete treatment within just 20 minutes.
During those 20 minutes, you may hear and feel a slight repetitive “tapping” coming from within the helmet – the coil’s magnetic pulses activating different parts of your brain. Deep TMS does not require any anesthesia; you’ll be awake and alert the whole time.
Some recipients report short-term side effects such as scalp discomfort at the stimulation site, slight tingling, moderate lightheadedness, or a headache. Keep your technician updated about your experience so they can modify your treatment plan accordingly.
According to BrainsWay, “Deep TMS treatment for depression normally includes a four-week, acute phase with five sessions a week, and an eight to 12-week continuation phase, with two sessions each week. In clinical practice, courses of treatment are typically between 30 and 36 sessions.”
Deep TMS treatment for OCD or anxiety can differ slightly, adding a phase with slightly more sessions.
Healing Starts Here: Plus by APN
Recovery from depression, anxiety, OCD, or a smoking addiction involves many layers. Deep TMS is an incredible tool that addresses the neurological level of healing for various mental health conditions, but like other treatment modalities, it does not stand alone.
At APN, we aim to support you in wellness in mind, body, and soul. We are prepared to meet you exactly where you are to help you recover, grow, and thrive.
Cutting-edge treatments like deep TMS, ketamine-assisted healing, hyperbaric oxygen treatment, neurofeedback, and stellate ganglion blocks (SGB) work in tandem with detox and withdrawal management, trauma therapy, in-person and virtual therapy options, and comprehensive addiction treatment programs.
Whether you visit All Points North Lodge in Edwards, CO, or one of our locations in Denver, Malibu, Boulder, or London, you will find expert care in a luxury environment. Most importantly, you will find your way forward.
- Noohi, Sima, and Susan Amirsalari. “History, Studies and Specific Uses of Repetitive Transcranial Magnetic Stimulation (rTMS) in Treating Epilepsy.” Iranian Journal of Child Neurology vol. 10,1 (2016): 1-8.
- Filipčić, Igor et al. “Efficacy of repetitive transcranial magnetic stimulation using a figure-8-coil or an H1-Coil in treatment of major depressive disorder; A randomized clinical trial.” Journal of Psychiatric Research vol. 114 (2019): 113-119. doi:10.1016/j.jpsychires.2019.04.020