TMS Therapy: What It Treats, Benefits, Side Effects, and Costs

Transcranial magnetic stimulation (TMS) is a type of brain stimulation therapy. It's a noninvasive treatment that uses electromagnetic ... HealthlineHealthConditionsDiscoverPlanConnectShopSubscribeWhatYouNeedtoKnowAboutTranscranialMagneticStimulation(TMS)TherapyMedicallyreviewedbyTimothyJ.Legg,PhD,PsyD—WrittenbyKirstenNunezonJanuary20,2021WhattoexpectPotentialbenefitsEffectivenessCandidatesRisksSideeffectsCostsSummaryShareonPinterestMontyRakusen/GettyImagesWhatisTMStherapy?Transcranialmagneticstimulation(TMS)isatypeofbrainstimulationtherapy.It’sanoninvasivetreatmentthatuseselectromagneticpulsestostimulatenervecells,whichmayimprovesymptomsofneurologicalormentalhealthdisorders.TMSismainlyusedtotreatdepression.It’shadsuccesshelpingpeoplewhodon’trespondtoantidepressantmedicationandpsychotherapy.Infact,in2008theFoodandDrugAdministration(FDA)approvedTMSforthispurpose.There’salsosomeevidencethatTMSmayhelpotherdisorders,likeanxietyandParkinson’sdisease.SinceTMSusesrepetitiveelectricalimpulses,it’ssometimescalledrepetitivetranscranialmagneticstimulation(rTMS).Thetermsareoftenusedinterchangeably.Ifyou’recuriousaboutthebenefitsandsideeffectsofTMS,readon.HowTMStherapyworksThetherapyisdonebyaTMStechnicianorTMSphysician.It’sanoutpatientprocedure,soitmaybedoneinamedicalclinic.Ifit’sdoneinahospital,youwon’tneedtostayovernight.Beforetheprocedure,you’llneedtoremoveitemsthataresensitivetomagnets,likejewelry.Here’swhatyoucanexpectduringTMS:Yourtechnicianwillhaveyouwearearplugstominimizetheclickingsoundofmagneticimpulses.They’llhaveyousitinacomfortablechair.Youwon’tneedgeneralanesthesia,andyou’llbeawakethroughoutthetreatment.Ifit’syourfirstsession,yourtechnicianwillmeasureyourheadtodeterminewheretoplacethemagneticcoil.They’llalsotakeothermeasurementstopersonalizethesettingsontheTMSmachine.Yourtechnicianwillplacethecoilabovethefrontareaofyourbrain.Next,they’llstartthetreatment.You’llhearaclickingsoundasthemagneticimpulsesarereleased.You’llalsofeelatappingorknockingsensationbeneaththemagneticcoil.Thetreatmentcanlast30to60minutes.Youcandriveyourselfhomeaftertheprocedureandresumenormalactivities.You’llneedtorepeattheprocedure5daysaweek,forabout4to6weeks.Theexactlengthofyourtreatmentdependsonyourresponseandspecificcondition.TMStherapybenefitsTherearemanypossiblebenefitsofTMStherapy.Researchersarestillstudyingtheprocedure,butitmayhelpthefollowingconditions:TMStherapyfordepressionTMSisprimarilyusedtotreatmajordepressivedisorder(MDD),sometimessimplycalleddepression.It’sgenerallyrecommendedforthosewhohaven’tfoundrelieffrommedicationandpsychotherapy.Thisiscalledtreatment-resistantdepression.Approximately30percentofpeoplewithdepressiondon’trespondtothesetreatments.Accordingto2015research,depressionislinkedtoreducedactivityintheprefrontalcortex.Thispartofthebrainisinvolvedwithdepressionsymptoms,likelowenergylevelsandappetitechanges.TMSmayhelpbystimulatingnervecellsandincreasingactivityinthisarea.TMStherapyforobsessive-compulsivedisorder(OCD)TMSmayimprovesymptomsofobsessive-compulsivedisorder(OCD).TheFDAapprovedTMSforOCDin2018.Aswithdepression,TMSisrecommendedifapersonwithOCDhasn’trespondedtomedicationandpsychotherapy.Accordingtoonestudy,peoplewithOCDoftenhaveincreasedactivitybetweentheprefrontalcortexandstriatum.ThishyperconnectivityisassociatedwithsevereOCDsymptoms.TMScanbeusedtoinhibittheactivityinthispartofthebrain,thusreducingOCDsymptoms.TMStherapyforanxietyAsTMStreatspsychologicaldisorderslikedepressionandOCD,itmayalsoeaseanxiety.That’sbecausetheseconditionsoftencauseanxietysymptoms.TMScouldalsobebeneficialforgeneralizedanxietydisorder(GAD).Inanxiety,there’softenincreasednervecellactivityintheprefrontalcortex.TMSmayreducetheactivityinthisregion,accordingtoa2019study.TMSforpost-traumaticstressdisorder(PTSD)Accordingtoa2019review,TMSshowedeffectivenessforpost-traumaticstressdisorder(PTSD).Asmentioned,TMScantargettheprefrontalcortex,whichregulateshowyouprocessfearandworry.A2018trialfoundthatTMSalongsidecognitiveprocessingtherapywaseffectiveforPTSD.Thetherapeuticeffectofthiscombinationlastedfor6months.TMSforstrokerehabilitationThere’ssomeevidencethatTMSmayhelpstrokerehabilitation.Astrokehappenswhenbloodflowtothebrainisblockedorreduced,causingbraincellstodie.Thiscanresultinlong-termlossofmusclemovement.Accordingtoresearch,usingTMSafterastrokecouldpromotemotorrecovery.Theideaisthatthemagneticimpulsescanaltertheactivityofthemotorcortex,thepartofthebrainthatcontrolsvoluntarymovement.A2017articlealsosharesthatTMSmayimprovedysphagia,ordifficultyswallowing,bystimulatingthemotorcortex.Theyaddthatdysphagiaaffects50percentofpeoplewhohaveexperiencedastroke.TMSforschizophreniaSchizophreniaisachronic,andoftensevere,psychiatricdisorder.Amainsymptomoftheconditionisauditoryhallucinations,whichaffect75percentofpeoplewithschizophrenia.Accordingtoa2019review,targetingthetemporoparietalcortexcouldbebeneficialforauditoryhallucinations.Thispartofthebrain,whichisinvolvedinlanguage,istypicallyoveractiveinschizophrenia.TMSforParkinson’sdiseaseParkinson’sdiseaseisaneurologicaldisorder.Itcausesmotordysfunction,includingtremors,balanceissues,andfreezingofgait.Freezingofgaitoccurswhenyoufeelfrozenandcan’tmovewhilewalking.A2020studyfoundthatTMSmayimprovefreezingofgait.Accordingtotheresearchers,TMSnormalizedtheconnectionsbetweenpartsofthebraininvolvedingaitfreezing.TMSforAlzheimer’sdiseaseTMSmighthavebenefitsforAlzheimer’sdisease,aformofdementia.Thisdisordercausesprogressivememorylossandcognitivedecline.Accordingtonewerresearch,it’sthoughtthatTMScouldhelpAlzheimer’sdiseasebyalteringtheneuralconnectionsinvolvedinmemoryandlearning.However,moreresearchisnecessarytounderstandhowTMScanmanageAlzheimer’sdisease.TMSforchronicpainTMScouldpotentiallyimprovechronicpainconditions,suchasfibromyalgia.A2017analysissharesthatitmayhelpbystimulatingthemotorcortexandcontrollingneurotransmittersinvolvedinpain.It’sworthnotingthatdepressionandchronicpainoftenoccurtogether.Depressioncanworsenchronicpain,soTMSmayhelpbytreatingdepressionsymptoms.TMSfornicotineaddictionNicotinereleasesdopamine,alsocalledthe“happyhormone.”Itsendssignalstotherewardsystemofyourbrain,includingtheprefrontalcortex,resultinginnicotinecravingsandaddiction.Accordingtoa2013study,TMScouldhelpreducenicotinecravingsbytargetingtheprefrontalcortex.TheresearchersthinkthatTMSpromotesthereleaseofdopamine,whichreducestheneedfornicotine.TMSformultiplesclerosisMultiplesclerosis(MS)isachronicautoimmunedisorderthataffectsthenervoussystem.Itcommonlycausesspasticity,ormuscletightnessthatmakesitdifficulttomove.Ina2019study,researchersusedTMSonthemotorcortexofpeoplewithMS.Thetreatment,combinedwithphysicaltherapy,wasfoundtodecreasespasticity.TMStherapysuccessrateTodate,TMStherapyhasmostlybeenstudiedasatreatmentfordepression.ThesuccessrateofTMSfordepressionispromising.Responseratesfordepressionarebetween30and64percent.Moreresearchisneededtounderstandthesuccessrateforothermedicalconditions.Whenistranscranialmagneticstimulationused?Ifyouhavedepression,adoctorwilllikelyrecommendantidepressantsandpsychotherapybeforeTMS.However,youmaybeagoodcandidateforTMSifyou:haveusedoneormoreantidepressantswithoutresultshaveexperiencednegativesideeffectswhenusingantidepressantsareachildorteenagerIfyou’reyoung,TMSmightbeanidealchoice.That’sbecauseyoungerpeoplearemorepronetodevelopingadversesideeffectsfromantidepressants.Whoshouldavoidthistreatment?TMSisconsideredsafe,butit’snotforeveryone.Youshouldavoidthistreatmentifyouhavemetalinyourhead,suchas:deepbrainstimulatorselectrodesneckorbrainstentsaneurysmclipsorcoilsshrapnelorbulletpiecesfacialtattooswithmetallicinkmetalplatescochlearimplantspermanentpiercingsThemagneticfieldsinTMScanmaketheseimplantsheatupormove,whichcancauseseriousinjuries.It’sOKtogetthetreatmentifyouhavebracesordentalfillings.YoumayalsoneedtoavoidTMSifyou:haveahistoryofepilepsyorseizuresaretakingstimulantshaveamedicalconditionthatincreasestheriskofseizuresSideeffectsoftranscranialmagneticstimulationTMSsideeffectsareuncommon.Ifcomplicationsdooccur,theymayinclude:mildheadaches(mostcommon)lightheadednessscalppainneckpaintinglingfacialtwitchingsleepinessalteredcognitionduringtreatmentSymptomslikeheadachesandlightheadednessusuallygoawayafterseveraltreatments.There’salsotheriskofseizures,butthissideeffectisrare.There’sa0.1percentriskofdevelopingseizuresduringacourseofTMStherapy.HowmuchdoesTMStherapycost?OnecourseofTMScancostbetween$6,000to$12,000outofpocket.Yourhealthinsuranceprovidermightoffercoverage,butthisdependsonyourmedicalhistory.YoumayberequiredtotryatleastfourantidepressantsbeforereceivingTMScoverage.Alternatively,theymightprovidecoverageifyouexperiencenegativereactionswhenusingantidepressants.IsTMStherapycoveredbyMedicare?Ifantidepressantsandpsychotherapydon’tworkforyou,MedicarewillcoverTMStherapy.DoyouhavetomissworkforTMStherapy?Sinceyou’reexpectedtogettreatment5daysaweekformultipleweeks,youmayhavetomissafewhoursofworkeachday.Thisdependsonyourschedule,thelocationoftheclinic,andthetimeofyourappointments.Onesessioncantakeanywherefrom30to60minutes,soyoumaybeabletodothetreatmentbeforeorafterwork.TakeawayTMStargetstheactivityofnervecellsinyourbrain,whichmayalleviatedepressionsymptoms.ItcouldalsohavebenefitfordisorderslikeOCD,anxiety,andPTSDaswell.Theproceduremayevenimprovemotordysfunction,makingitpotentiallyhelpfulforParkinson’sdisease,multiplesclerosis,orstrokerehabilitation.Ifyou’reinterestedinTMS,talkwithadoctor.Youmaybeagoodcandidateifyou’reyoung,havealowriskofseizures,andhaven’tfeltrelieffromantidepressants.LastmedicallyreviewedonJanuary20,2021MedicallyreviewedbyTimothyJ.Legg,PhD,PsyD—WrittenbyKirstenNunezonJanuary20,2021MoreinNavigatingDepressionHowtoManageTreatment-ResistantDepressionIfYou’reBattlingAnxietyandDepression,Don’tLetAnyoneTellYouIt’s“JustStress”PTSDandDepression:HowAreTheyRelated?ViewallReadthisnextHowtoManageTreatment-ResistantDepressionMedicallyreviewedbyTimothyJ.Legg,PhD,PsyDTreatment-resistantdepressionreferstodepressionthatdoesn’trespondtocommontreatments.Despitethename,therearestilltreatmentsthatcan…READMOREIfYou’reBattlingAnxietyandDepression,Don’tLetAnyoneTellYouIt’s“JustStress”Formany,anxietyanddepressionarereal,andit'stimewestopthemwritingthemoffassomethingthatwillgoaway.READMOREPTSDandDepression:HowAreTheyRelated?MedicallyreviewedbyTimothyJ.Legg,PhD,PsyDPTSDanddepressionaredifferentmentalhealthconditions,buttheyhavemanysymptomsincommonsuchassleepdifficulties,emotionaloutbursts,and…READMORE