Transcranial magnetic stimulation - Mayo Clinic

Transcranial magnetic stimulation (TMS) is a noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve ... COVID-19:Advice,updatesandvaccineoptions FindoutaboutCOVID-19,COVID-19vaccines,andMayoClinicpatientandvisitorupdates. Skiptositenavigation SkiptoContent ThiscontentdoesnothaveanEnglishversion.ThiscontentdoesnothaveanArabicversion. SectionsforTranscranialmagneticstimulationAboutDoctors&DepartmentsCareatMayoClinic Print OverviewTranscranialmagneticstimulation(TMS)isanoninvasiveprocedurethatusesmagneticfieldstostimulatenervecellsinthebraintoimprovesymptomsofdepression.TMSistypicallyusedwhenotherdepressiontreatmentshaven'tbeeneffective. Thistreatmentfordepressioninvolvesdeliveringrepetitivemagneticpulses,soit'scalledrepetitiveTMSorrTMS. Howitworks Repetitivetranscranialmagneticstimulation(rTMS) Openpop-updialogbox Close Repetitivetranscranialmagneticstimulation(rTMS) Repetitivetranscranialmagneticstimulation(rTMS) Intranscranialmagneticstimulation(TMS),anelectromagneticcoilplacedagainstthescalpcreatesamagneticfieldthatstimulatescertainareasofthebrain. DuringanrTMSsession,anelectromagneticcoilisplacedagainstyourscalpnearyourforehead.Theelectromagnetpainlesslydeliversamagneticpulsethatstimulatesnervecellsintheregionofyourbraininvolvedinmoodcontrolanddepression.It'sthoughttoactivateregionsofthebrainthathavedecreasedactivityindepression. ThoughthebiologyofwhyrTMSworksisn'tcompletelyunderstood,thestimulationappearstoimpacthowthebrainisworking,whichinturnseemstoeasedepressionsymptomsandimprovemood. Therearedifferentwaystoperformtheprocedure,andtechniquesmaychangeasexpertslearnmoreaboutthemosteffectivewaystoperformtreatments.Products&ServicesBook:MayoClinicFamilyHealthBook,5thEditionNewsletter:MayoClinicHealthLetter—DigitalEditionShowmoreproductsfromMayoClinic Whyit'sdoneDepressionisatreatablecondition,butforsomepeople,standardtreatmentsaren'teffective.RepetitiveTMSistypicallyusedwhenstandardtreatmentssuchasmedicationsandtalktherapy(psychotherapy)don'twork.   Thereisaproblemwith informationsubmittedforthisrequest.Review/updatethe informationhighlightedbelowandresubmittheform. FromMayoClinictoyourinbox Signupforfree,andstayuptodateonresearchadvancements,healthtipsandcurrenthealthtopics,likeCOVID-19,plusexpertiseonmanaginghealth. Email ErrorEmailfieldisrequired ErrorIncludeavalidemailaddress LearnmoreaboutMayoClinic’suseofdata. 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Sorrysomethingwentwrongwithyoursubscription Please,tryagaininacoupleofminutes Retry RequestanAppointmentatMayoClinic RisksRepetitiveTMSisanoninvasiveformofbrainstimulationusedfordepression.Unlikevagusnervestimulationordeepbrainstimulation,rTMSdoesnotrequiresurgeryorimplantationofelectrodes.And,unlikeelectroconvulsivetherapy(ECT),rTMSdoesn'tcauseseizuresorrequiresedationwithanesthesia. Generally,rTMSisconsideredsafeandwell-tolerated.However,itcancausesomesideeffects. CommonsideeffectsSideeffectsaregenerallymildtomoderateandimproveshortlyafteranindividualsessionanddecreaseovertimewithadditionalsessions.Theymayinclude: Headache Scalpdiscomfortatthesiteofstimulation Tingling,spasmsortwitchingoffacialmuscles Lightheadedness Yourdoctorcanadjustthelevelofstimulationtoreducesymptomsormayrecommendthatyoutakeanover-the-counterpainmedicationbeforetheprocedure. UncommonsideeffectsSerioussideeffectsarerare.Theymayinclude: Seizures Mania,particularlyinpeoplewithbipolardisorder Hearinglossifthereisinadequateearprotectionduringtreatment MorestudyisneededtodeterminewhetherrTMSmayhaveanylong-termsideeffects. HowyouprepareBeforehavingrTMS,youmayneeda: Physicalexamandpossiblylabtestsorothertests Psychiatricevaluationtodiscussyourdepression TheseevaluationshelpmakesurethatrTMSissafeandagoodoptionforyou. Tellyourdoctorormentalhealthproviderif: You'repregnantorthinkingofbecomingpregnant. Youhaveanymetalorimplantedmedicaldevicesinyourbody.Insomecases,peoplewithmetalimplantsordevicescanhaverTMS.However,duetothestrongmagneticfieldproducedduringrTMS,theprocedureisnotrecommendedforsomepeoplewhohavethefollowingdevices: Aneurysmclipsorcoils Stents Implantedstimulators Implantedvagusnerveordeepbrainstimulators Implantedelectricaldevices,suchaspacemakersormedicationpumps Electrodesformonitoringbrainactivity Cochlearimplantsforhearing Anymagneticimplants Bulletfragments Anyothermetaldeviceorobjectimplantedinyourbody You'retakinganymedications,includingprescriptionorover-the-countermedications,herbalsupplements,vitaminsorothersupplements,andthedosages. Youhaveahistoryofseizuresorafamilyhistoryofepilepsy. Youhaveothermentalhealthdisorders,suchassubstancemisuse,bipolardisorderorpsychosis. Youhavebraindamagefromillnessorinjury,suchasabraintumor,astrokeoratraumaticbraininjury. Youhavefrequentorsevereheadaches. Youhaveanyothermedicalconditions. You'vehadpriortreatmentwithrTMS,andwhetheritwashelpfulintreatingyourdepression. BeforeyourfirstappointmentRepetitiveTMSisn'tinvasive,doesn'trequireanesthesiaandcanbeperformedonanoutpatientbasis.Youdon'tneedtoarrangeforsomeonetodriveyouhomeaftertreatment—unless,forthefirsttreatment,youpreferadriveruntilyougetasenseofhowyou'llfeelafterward. Beforeconsideringtreatment,checkwithyourhealthinsurancecompanytoseewhetherrTMSiscovered.Yourpolicymaynotcoverit. WhatyoucanexpectRepetitiveTMSisusuallydoneinadoctor'sofficeorclinic.Itrequiresaseriesoftreatmentsessionstobeeffective.Generally,sessionsarecarriedoutdaily,fivetimesaweekforfourtosixweeks. YourfirsttreatmentBeforetreatmentbegins,yourdoctorwillneedtoidentifythebestplacetoputthemagnetsonyourheadandthebestdoseofmagneticenergyforyou.Yourfirstappointmenttypicallylastsabout60minutes. Mostlikely,duringyourfirstappointment: You'llbetakentoatreatmentroom,askedtositinarecliningchairandgivenearplugstowearduringtheprocedure. Anelectromagneticcoilwillbeplacedagainstyourheadandswitchedoffandonrepeatedlytoproducestimulatingpulses.Thisresultsinatappingorclickingsoundthatusuallylastsforafewseconds,followedbyapause.You'llalsofeelatappingsensationonyourforehead.Thispartoftheprocessiscalledmapping. Yourdoctorwilldeterminetheamountofmagneticenergyneededbyincreasingthemagneticdoseuntilyourfingersorhandstwitch.Knownasyourmotorthreshold,thisisusedasareferencepointindeterminingtherightdoseforyou.Duringthecourseoftreatment,theamountofstimulationcanbechanged,dependingonyoursymptomsandsideeffects. DuringeachtreatmentOncethecoilplacementanddoseareidentified,you'rereadytobegin.Here'swhattoexpectduringeachtreatment: You'llsitinacomfortablechair,wearingearplugs,withthemagneticcoilplacedagainstyourhead. Whenthemachineisturnedon,you'llhearclickingsoundsandfeeltappingonyourforehead. Theprocedurewilllastabout40minutes,andyou'llremainawakeandalert.Youmayfeelsomescalpdiscomfortduringthetreatmentandforashorttimeafterward. AftereachtreatmentYoucanreturntoyournormaldailyactivitiesafteryourtreatment.Typically,betweentreatments,youcanexpecttoworkanddrive. ResultsIfrTMSworksforyou,yourdepressionsymptomsmayimproveorgoawaycompletely.Symptomreliefmaytakeafewweeksoftreatment. TheeffectivenessofrTMSmayimproveasresearcherslearnmoreabouttechniques,thenumberofstimulationsrequiredandthebestsitesonthebraintostimulate. OngoingtreatmentAftercompletionofanrTMStreatmentseries,standardcarefordepression―suchasmedicationandpsychotherapy―mayberecommendedasongoingtreatment. It'snotyetknownifmaintenancerTMSsessionswillbenefityourdepression.Thisinvolvescontinuingtreatmentwhenyouaresymptom-freewiththehopethatitwillpreventthereturnofsymptoms. However,ifyourdepressionimproveswithrTMS,andthenlateryouhaveanotherepisodeofsymptoms,yourrTMStreatmentcanberepeated.Thisiscalledre-induction.Someinsurancecompanieswillcoverre-induction. IfyoursymptomsimprovewithrTMS,discussongoingormaintenancetreatmentoptionsforyourdepressionwithyourdoctor. Clinicaltrials ExploreMayoClinicstudiesoftestsandprocedurestohelpprevent,detect,treatormanageconditions. ByMayoClinicStaff TranscranialmagneticstimulationcareatMayoClinic RequestanAppointmentatMayoClinic Doctors&Departments Nov.27,2018 Print Shareon:FacebookTwitter Showreferences Brainstimulationtherapies.NationalInstituteofMentalHealth.https://www.nimh.nih.gov/health/topics/brain-stimulation-therapies/brain-stimulation-therapies.shtml#part_152879.AccessedOct.2,2018. HaesebaertF,etal.Usefulnessofrepetitivetranscranialmagneticstimulationasamaintenancetreatmentinpatientswithmajordepression.WorldJournalofBiologicalPsychiatry.2018;19:74. TrangleM,etal.Depression,adultinprimarycare.InstituteforClinicalSystemsImprovement.https://www.icsi.org/guidelines__more/catalog_guidelines_and_more/catalog_guidelines/catalog_behavioral_health_guidelines/depression/.AccessedOct.2,2018. AskMayoExpert.Transcranialmagneticstimulation.Rochester,Minn.:MayoFoundationforMedicalEducationandResearch;2017. HoltzheimerPE.Unipolardepressioninadults:Indications,efficacy,andsafetyoftranscranialmagneticstimulation(TMS).https://www.uptodate.com/contents/search.AccessedOct.2,2018. HoltzheimerPE.Techniqueforperformingtranscranialmagneticstimulation(TMS).https://www.uptodate.com/contents/search.AccessedOct.2,2018. ECT,TMSandotherbrainstimulationtherapies.NationalAllianceonMentalIllness.https://www.nami.org/Learn-More/Treatment/ECT,-TMS-and-Other-Brain-Stimulation-Therapies.AccessedOct.2,2018. GarnaatSL,etal.Updatesontranscranialmagneticstimulationformajordepressivedisorder.PsychiatricClinicsofNorthAmerica.2018;41:419. GuoQ,etal.Updatedreviewontheclinicaluseofrepetitivetranscranialstimulationinpsychiatricdisorders.NeuroscienceBulletin.2017;33:747. CroarkinPE(expertopinion).MayoClinic,Rochester,Minn.Oct.28,2018. Related Bipolardisorder Depression(majordepressivedisorder) Functionalneurologicdisorder/conversiondisorder Mentalillness Obsessive-compulsivedisorder(OCD) Repetitivetranscranialmagneticstimulation(rTMS) Showmorerelatedcontent NewsfromMayoClinic Innovativetreatmentbringsrelieftomanwhoexperiencedhundredsofseizuresdaily Jan.28,2021,08:04p.m.CDT Products&Services Book:MayoClinicFamilyHealthBook,5thEdition Newsletter:MayoClinicHealthLetter—DigitalEdition ShowmoreproductsandservicesfromMayoClinic MayoClinicinRochester,Minn.,hasbeenrecognizedasoneofthetopPsychiatryhospitalsinthenationfor2021-2022byU.S.News&WorldReport. Learnmoreaboutthistophonor TranscranialmagneticstimulationAboutDoctors&DepartmentsCareatMayoClinic Advertisement MayoClinicdoesnotendorsecompaniesorproducts.Advertisingrevenuesupportsournot-for-profitmission. Advertising&Sponsorship Policy Opportunities AdChoices MayoClinicPress Checkoutthesebest-sellersandspecialoffersonbooksandnewslettersfromMayoClinicPress. 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