Transcranial magnetic stimulation
Clinical rTMS in the United States
TMS (also called repetitive TMS, or rTMS) has been extensively studied for the treatment of depression, as well as other brain disorders. rTMS involves the non-invasive application of a coil to the scalp for brief periods, usually around 20 - 40 minutes at a time. The coil generates a magnetic field that can stimulate neurons in the brain. It is completely non-invasive, unlike VNS, which requires outpatient surgery for implantation. For rTMS, the coil is simply positioned against the side of the head. It does not involve anesthesia, unlike ECT. The magnetic energy is applied daily, usually for 5 consecutive treatments, and a course of treatment typically lasts from 3 - 6 weeks. Treatment can be delivered in an office setting, and hospitalization is not necessary.
Unlike medications, which affect the entire body, rTMS is targeted to a specific part of the brain. It is an extremely safe treatment, and serious side effects, such as an induced seizure, are very unlikely, i.e. less than 1 in 1000. More common are mild irritation at the site of stimulation, which can often be relieved by re-positioning the coil. While safe, not all patients will benefit from rTMS, and it should only be prescribed by licensed MD's/DO's.
The FDA recently approved a new device, the Neurostar TMS system, for the treatment of Major Depressive Disorder in adult patients who have failed to improve from a prior antidepressant medication in the current episode. This availability of rTMS therapy will provide a new option for persons who have trouble tolerating the side effects of antidepressant medications. Results from a recent clinical trial, sponsored by Neuronetics, the manufacturer of the Neurostar device, have been promising. News of the FDA approval was announced in a company press release on October 8, 2008. Clinical rTMS has been available in Canada for several years.
Clinical rTMS at the U-M Depression Center
rTMS is currently available for depressed patients at the U-M Department of Psychiatry/Depression Center through the Psychiatric Neuromodulation Program. The University of Michigan has conducted clinical trials in rTMS (sponsored by Neuronetics) and has had treatment availability since April of 2009.
If you are interested in rTMS for your depression, please visit the Department of Psychiatry Web site page detailing more information about the treatment and consultation process.
Last updated: 01/27/2010
