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Newer Treatments – TMS / TBS

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  • Newer Treatments – TMS / TBS
ShapeNewer treatments - TMS / TBS

Transcranial Magnetic Stimulation ( TMS )

Transcranial magnetic stimulation (TMS) relies on two basic principles of physics-magnetism and electricity. A magnetic field is created by the TMS machine which is used in this treatment, electric current is not given in this procedure. Normally human brain cells and nerves use a small amount of electrical current generated in the brain by itself, to send and relay information in the brain. The TMS machine creates a harmless magnetic field around the brain and influences the brain’s electrical activity and if targeted at specific areas which impact the mood, decision making, emotions, sense of pleasure etc then this makes TMS work and treat many psychiatric and neurological conditions. Success rate of TMS is approximately 60%-80%. Theta burst stimulation (TBS) has a success rate of almost 90%.

What conditions it treats?

  • Depression especially Treatment resistant Depression where medication and Psychotherapy is not fully effective.
  • Obsessive Compulsive Disorder ( OCD)
  • Migraines
  • Smoking cassation
  • Generalized Anxiety Disorder
  • Schizophrenia
  • Bipolar Affective Disorder
  • Chronic pain
  • Borderline Personality Disorder
  • Eating Disorders
  • Parkinson’s Disease
  • Others ( eg ASD/ ADHD etc )

What is unique about this treatment ?

  • US, Food and Drug Administration ( FDA) approved
  • Painless
  • Non-invasive ( no surgery or anaesthesia)
  • No radiation
  • Safe
  • No side effects
  • Area of the brain where the magnetic stimulation is given and the dose it is given at is first assessed by the doctor.
How does it work?

We deliver repetitive magnetic pulses to the brain hence it is called rTMS. During the session a coil which delivers the magnetic impulses is placed against the scalp of the brain in a specific area (eg dorsolateral prefrontal cortex in Depression) which stimulates the nerve cells in the region of the brain involved in mood control or depression. It activates the neurons that have decreased activity due to depression.

Theta Burst Stimulation ( TBS )

It is a newer, accelerated version of TMS where the magnetic field stimulates the nerve cells but the pulse pattern of delivery is a triplet of 5Hz burst which delivers 15 pulses in a second. Using this burst pattern speeds up the treatment making it 5-6 times faster than other protocols. It is an FDA approved treatment for Depression.

How many sessions are needed ?

TMS needs 20-30 sessions in total. Duration of each session is 20 or 37 minutes depending on which protocol is being used. In one week 5 sessions are given with a break of 2 days. Hence 30 sessions are completed in 6 weeks. While TBS is completed in 10 sessions hence requires 2 weeks. Each session is of short duration (3 minutes) however different protocols are used so timing varies.