Transcranial Magnetic Stimulation (TMS) for Treating Depression
TMS is a type of magnetic therapy for treating depression. This technique has been found to be successful at treating depression in many patients, and has been conclusively verified to achieve positively results in a number of scientific studies.
This treatment has been shown to particularly be successful for treating depression in patients who have not previously responded well to traditional forms of treatment, such as using antidepressants. For many people, these medications have little or no impact on their illness. As a result, many people who suffer from depression end up in and out of hospitals as they unsuccessfully battle with their depression.
Transcranial magnetic stimulation (TMS) uses pulses of magnetic energy on a specific region of the brain where depression triggers are thought to be centered. Studies carried out have shown that the technique has worked for between 50% and 70% of depression patients who have tried it.
It is estimated that between 10% and 30% of people who suffer from clinical depression are either partially, or completely, resistant to drug therapies, and researchers are hopeful that this new magnetic healing method will be able to provide an effective treatment for these people.
How Does TMS Work?
TMS involves applying a magnetic field to a patient’s brain using a coil which is positioned over the scalp. Before the treatment begins, this coil is aligned with the patient’s left prefrontal cortex. This is the area of the brain most associated with mood-related disorders. The treatment area is only about the size of a quarter.
A brief magnetic pulse is transmitted through the scalp to ensure that the right area is being targeted for treatment. If the correct region is being targeted, the patient’s right thumb will twitch. The device is then aimed 5 centimeters forward from this spot.
Then, the patient receives around 3,000 pulses a minute from the device. The treatment last about 40 minutes and is repeated five times a week for a period of six weeks. The device beams the magnetic field in a series of rapid 10 second pulses. At the conclusion of the treatment series, patients are assessed for improvement.
Nobody yet completely understands how TMS works to relieve depression. However, many physicians and researchers suspect that it the therapy acts to stimulate electrical activity in the area of the brain affected by depression. It is also believed that stimulating brain cells in the prefrontal cortex triggers a chain reaction that, in turn, stimulates deeper brain regions involved with mood. People who suffer from depression tend to display less electrical activity in this region than people who are not depressed, and research indicates that the magnetic pulse waves cause an increase.
What are the Benefits of TMS for Depression?
TMS has a number of important benefits. First, it is a very simple and painless procedure that doesn’t induce patients to have a fit (which can happen when using ECT – electro-convulsive therapy). Second, because there is no need to use general anesthesia, a large medical team isn’t needed on hand. Third, there have been few reported side-effects, although some patients have reported a sensation similar to a finger flicking against the side of their head. Others have have reported getting mild headaches.
Research Supporting TMS for Depression
A scientific study researching the effectiveness of TMS for depression was published in the October 2010 issue of Brain Stimulation.
“We wanted to address the question of whether the benefit of TMS (transcranial magnetic stimulation) can be sustained over a reasonable time,” said Dr. Philip Janicak, the leader of the research study, who is a professor of psychiatry at Rush University Medical Center. “Based on this trial, the answer is yes.”
Although this one study is far too small to provide definitive and absolute results, it does indicate that the beneficial effects of TMS can be sustained for a period of over 6 months, and the treatment can be done safely. While using TMS in conjunction with antidepressant medications, there were no increased associated risks.
The scientific researchers grouped and organized 301 people who had been previously diagnosed with depression into two main groups: those who would be receiving either real or fake magnetic therapy for a period of about 6 weeks. The fake, or placebo, treatments had a similar feel to the real one.
The 142 participants who received and had a good response to the actual magnetic therapy treatments then went on to enter a 21 day transitional phase. During this phase, the participants were tapered off of the TMS treatments and then began a regimen of prescribed anti-depressant medications.
Of those 142 patients, 121 of them (or about 85%) completed the transitional phase of the treatment without suffering a relapse, and 99 of the participants agreed to enter a 24 week, follow-up study.
During this 24 week period, only 10 of the 99 participants (or about 10%) had a relapse of symptoms. Of the 38 participants who did experience a worsening of symptoms, which required additional TMS treatments, 32 of them (84%) experienced improvement and avoided having further relapses. At the end of the day, 75% of the study participants had a sustained, and complete positive response to the treatments.
Another study regarding the use of TMS for treating depression was published the Archives of General Psychiatry.
In this study, researchers administered magnetic therapy to half of a group of 190 adults who had experienced depression for a period of at least three months, but less than five years, and who had taken prescribed medicine for their depression, but did not experience sufficient, positive results. The other half of the study group was given a placebo treatment – simulated magnetic therapy that was not distinguishable from the actual therapy, the researchers said.
After three weeks, about 14% of the patients in the group who were receiving actual magnetic therapy reported that they were no longer experiencing depression, compared with only 5% of those who were receiving the fake treatment.
The researchers continued applying the magnetic treatment for three additional weeks for those who continued to remained depressed, and offered the real treatment to the participants who’d received the placebo treatment. After that additional three week period, about 30% reported that they were no longer experiencing depression, according to the researchers.
“We have settled a fundamental question about (TMS) therapy, which is, ‘Does it work?'” said the lead author of the study, Dr. Mark George, a professor of psychiatry, radiology and neuroscience at the Medical University of South Carolina. “The answer is ‘yes.'”
“In a rigorous, industry-free multi-site trial, with a convincing sham, we found unambiguously that TMS worked better than the sham. It’s watershed,” George stated.
Other Uses of TMS
Trans-cranial magnetic stimulation (TMS) was approved by the FDA in 2008 for treating medication-resistant depression. In 2013, the FDA cleared it for use for migraines. Researchers have also probed its effectiveness for treating other disorders, such as anxiety and PTSD. Other studies indicate that it could helpful for memory.
The continued increase in the occurrence of regulatory approval in recent years has led to more psychiatric offices and treatment centers offering this treatment to their patients. Particularly those patients who have not been able to find relief via other, more traditional methods.