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TRANSCRANIAL MAGNETIC STIMULATION

magnetic brain stimulation therapy

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Brain magnetic stimulation (Transcranial Magnetic Stimulation or TMS) is a safe and non-invasive new medical technology that uses the electric field generated by magnetic pulses to regulate the activity of specific brain circuits. As a non-drug brain circuit therapy (brain circuit therapy), TMS treatment only affects specific neural circuits in the brain, and has no effect on the chemical composition of other parts of our body. In the past 30 years, a large amount of clinical research data has supported the therapeutic effect of TMS, especially for psychiatric and neurological diseases, such as depression, anxiety, obsessive-compulsive disorder, dementia, chronic neuralgia, stroke rehabilitation, Tinnitus etc.

To learn more about the principles of TMS, please watch the video:https://youtu.be/tzLBTie9-fU

The latest brain neuroscience research has found that symptoms such as prolonged depression, loss of interest in things, negative thinking, self-blame and guilt, and suicidal thoughts in patients with depression may be due to the fact that the brain is responsible for cognitive/thinking functions (left dorsolateral prefrontal cortex hypoactivity) and emotional function (hyperactivity in the anterior cingulate cortex, amygdala, etc.) neural circuits that are not functioning effectively[1,2]. The US Food and Drug Administration (FDA) approved the first-generation non-navigated TMS technology in 2008 for the treatment of depressed patients who do not respond well to antidepressants[3-5]. TMS treatment uses magnetic pulses generated by electromagnetic coils to regulate the activity of neural circuits in the brain related to cognition/thinking and emotional functions according to the principle of neural plasticity, so as to achieve the effect of treating depression[6,7], There will be no side effects and withdrawal problems caused by any drug treatment.

If the patient finds that the effect of drug treatment is not satisfactory, cannot tolerate the side effects of drug treatment, or is worried about possible withdrawal symptoms after stopping the drug, TMS treatment can be considered. The standard course of TMS treatment for depression usually takes 4-6 weeks, 3-5 days a week, once a day, and each treatment takes about 30 minutes. During each TMS session, the patient will sit comfortably in a reclining chair and remain awake without any sedation or anesthesia. After each TMS treatment, patients can immediately return to daily life, including driving, returning to work or school.

To learn more about the TMS treatment process, watch the video:

https://youtu.be/TOXuf7NRzog

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To achieve the best therapeutic effect, TMS therapy needs to precisely target specific neural circuits in the brain[8,9]. Each of us is a unique individual with different brain size, structure, magnetic pulse strength required for treatment and optimal treatment location. Therefore, our clinic adopts the SmartFocus® TMS system, which has been clinically verified by brain surgery and has been approved by the US FDA for the treatment of depression, and is equipped with the most advanced three-dimensional magnetic resonance brain imaging (3D brain MRI)/electric field navigation (E-field navigation) technology to provide each patient with individualized precise TMS treatment. The latest clinical data show that after a course of SmartFocus® TMS treatment, 77% of the patients' depressive symptoms were significantly improved, and 50.3% of the patients' depressive symptoms were completely relieved[10], compared with the first generation of non-navigation TMS technology, the treatment effect is significantly improved[5,10].

Potential side effects of TMS treatment include scalp discomfort at the site of stimulation, transient headaches, and mild forehead or facial muscle twitching during treatment. TMS treatment has a rare risk of inducing a seizure (seizure), about 1 in 30,000, which is similar to the risk of inducing a seizure with common antidepressants (0.1%).

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To learn more about SmartFocus® TMS treatment, please visit:

https://nexstim.com/patients/depression/

https://smartfocusmstherapy.com/

 

Reference

1. Padmanabhan, JL, Cooke, D., Joutsa, J., Siddiqi, SH, Ferguson, M., Darby, RR, . . . Fox, MD (2019). A Human Depression Circuit Derived From Focal Brain Lesions. Biological Psychiatry, 86(10), 749-758.

2. Jodie P. Gray, MS ,, Veronika I. Müller, Ph.D. ,, Simon B. Eickhoff, MD ,, & Peter T. Fox, MD Multimodal Abnormalities of Brain Structure and Function in Major Depressive Disorder: A Meta -Analysis of Neuroimaging Studies. American Journal of Psychiatry, 0(0), appi.ajp.2019.19050560.

3. O'Reardon, JP, Solvason, HB, Janicak, PG, Sampson, S., Isenberg, KE, Nahas, Z., . . . Sackeim, HA (2007). Efficacy and Safety of Transcranial Magnetic Stimulation in the Acute Treatment of Major Depression: A Multisite Randomized Controlled Trial. Biological Psychiatry, 62(11), 1208-1216.

4. Lisanby, SH, Husain, MM, Rosenquist, PB, Maixner, D., Gutierrez, R., Krystal, A., . . . George, MS (2009). Daily left prefrontal repetitive transcranial magnetic stimulation in the acute treatment of major depression: Clinical predictors of outcome in a multisite, randomized controlled clinical trial. Neuropsychopharmacology, 34(2), 522-534.

5. Carpenter, LL, Janicak, PG, Aaronson, ST, Boyadjis, T., Brock, DG, Cook, IA, . . . Demitrack, MA (2012). Tracranial Magnetic Stimulation for Major Depression: A Multisite, Naturalistic, Observational Study of Acute Treatment Outcomes in Clinical Practice. Depression and Anxiety, 29(7), 587-596.

6. Hadas, I., Sun, Y., Lioumis, P., Zomorrodi, R., Jones, B., Voineskos, D., . . . Daskalakis, ZJ (2019). Association of Repetitive Transcranial Magnetic Stimulation Treatment With Subgenual Cingulate Hyperactivity in Patients With Major Depressive Disorder: A Secondary Analysis of a Randomized Clinical Trial. JAMA Network Open, 2(6), e195578-e195578.

7. Eshel, N., Keller, CJ, Wu, W., Jiang, J., Mills-Finnerty, C., Huemer, J., . . . Etkin, A. (2020). Global connectivity and local excitability changes Underlie antidepressant effects of repetitive transcranial magnetic stimulation. Neuropsychopharmacology.

8. Rosen, AC, Bhat, JV, Cardenas, VA, Ehrlich, TJ, Horwege, AM, Mathalon, DH, . . . Yesavage, JA (2021). Targeting location relates to treatment response in active but not sham rTMS stimulation. Brain Stimulation, 14(3), 703-709.

9. Modak, A., & Fitzgerald, PB (2021). Personalizing transcranial magnetic stimulation for depression using neuroimaging: A systematic review. The World Journal of Biological Psychiatry, 1-23. doi:10.1080/15622975.2021.1 907710

10. Nexstim Gives an Update on its Promising Treatment Results of Major Depressive Disorder Press Release, Helsinki, 12 March 2021 at 10.00 (EET): https://nexstim.com/news-and-events/news/press-release/news /nexstim-gives-an-update-on-its-promising-treatment-results-of-major-depressive-disorder/

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