Transcranial Magnetic Stimulation: What is it and how is it used?

Over the recent decades, electrophysiological studies have much broadened the understanding of brain’s normal activity and its pathological conditions. Technological advances have played a major role in either attaining therapeutic goals or doing cutting-edge researches in a variety of disciplines like neurology, psychiatry and psychology. One of the impressive achievements of electrophysiology seems to be “brain stimulation” and technologies thereof. Transcranial Magnetic Stimulation” (TMS) is one of these technologies, which has recently acquired a great deal of reputation. TMS is the induction of an electric current to the brain cortex through a magnetic field outside the brain.

What is the historical background of TMS?

From a historic point of view, first it was Faraday, in 1831, arguing that the relation between electrical energy and magnetic field was reciprocal. Further, experiments revealed that the use of magnetic coils over a person’s head could bring about feelings of dizziness and giddiness. Later, magnetic coils were used to treat mental disorders of depression and neurosis via electrical effects of the magnetic field created on the scalp. The current use of electromagnetic induction for transcranial stimulation dates back to 1985. At that time, Barker and his colleagues invented the initial type of TMS in Sheffield, UK. At present, devices for repetitive electromagnetic induction have been developed into a structure that different parameters, e.g. the ability to increase or decrease the magnetic energy on cortical areas, can be precisely modified to fit best the treatment of various psychological disorders. The Food and Drug administration (FDA) of the United States also granted approval to this method on October 8th, 2008.

What is the basic science behind TMS?

Generally, TMS equipment is simple and consists of a transformer for charging a big capacitor, which instantly discharges to create a magnetic field pulse in the coil for stimulation. In this type of treatment, the magnetic field produced by the first coil is transferred to the second, meaning the brain, to stimulate the nerve cells located there. When the magnetic fields go through the brain, they generate a secondary electric current, which changes the electrical load of the nerve cells. This technology has the ability to easily excite regions between the white matter and the gray matter of the brain.

What is the current state of TMS use in mental health treatment?

TMS is slowly gaining popularity as a useful therapeutic tool in many psychiatric disorders though FDA has cleared its role in Major unipolar depression and obsessive-compulsive disorder. TMS therapy has been shown to work particularly well in cases of treatment resistance when patients do not respond well to medication. TMS offers an empirically-based, medical device treatment option that can appeal to those who do not find psychotherapy to be a sufficient form of support. TMS is a safe and effective treatment primarily for depression, but can also be a helpful treatment for anxiety disorders, PTSD, and obsessive compulsive disorder.

How much does TMS treatment cost?

The cost of TMS treatment can vary depending on several factors, including location, number of sessions, and treatment provider. Many insurance providers now cover TMS treatment for certain mental health conditions. However, coverage can vary depending on your specific insurance plan and the diagnosis for which TMS is being recommended. Like many forms of therapy, major insurance companies might cover the cost of TMS therapy. Since it is often an FDA-approved course of treatment, more insurance companies may add the procedure to their list of coverage’s. However, every insurance provider has different policies, and your policy may vary from that of other states.

Sources

• Barker AT, Jalinous R, Freeston IL. Non-invasive magnetic stimulation of human motor cortex. Lancet. 1(8437):1106–7.
• George MS, Belmaker RH. Transcranial Magnetic Stimulation in Neuropsychiatry. 1st ed. . Vol. 37. Washington: American Psychiatric Press; Inc; 2007. pp. 269–87.
• Marcolin MA, Padberg F. In: Transcranial Brain Stimulation for Treatment of Psychiatric Disorders. 1st ed. Kaschka WP, Gattaz WF, editors. Switzerland: S. Karger; 2007. pp 230.