rTMS treatment and how it works?

rTMS treatment, what is it used for and how does it work?


What is rTMS?

Well for starters let me tell you what the acronym rTMS stands for so we’ll all be on the same page. Once we’re done with that I’ll get down to business and answer your question.  Okay?  Okay.

rTMS spelled out is Repetitive Transcranial Magnetic Stimulation.  I know it’s a mouthful.  It’s in the final testing phase to treat a variety of conditions and illnesses.  It is already being used to treat others one of them being depression and for obvious reasons, that’s the condition I’ll be discussing today.

This is the medical explanation; rTMS is a non-invasive method used to cause depolarization in the neurons of the brain.  rTMS uses electromagnets to create weak electric currents using a quick changing magnetic field. This can increase activity in specific areas of the brain.

same as those used in an MRI.

I know I know ENOUGH ALREADY WITH ALL THIS MEDICAL GOBBLELYGOOP!!  Trust me, you have no idea how rusty my Anatomy and Physiology is.  I would read something and say to myself “self, what the heck is an  anterior prefrontal cortex in relation to a cerebral cortex???”   HELP!!!  I promise I’m almost done and then I will put in laymen’s terms a very concise explanation we can all understand…ok?  I just wanted to make sure you had the full medical explanation.  So please just be patient and hang in there with me.

A fairly small plastic encased coil and an electromagnet shaped like the letter C is applied to the left scalp at the anterior of the prefrontal lobe of the cerebral cortex. Electromagnetic induction generates weak electrical currents delivered in magnetic pulses 2 to 3 centimeters into the left prefrontal lobe of the cerebral cortex.  This procedure is not painful.  The magnetic pulses are basically the same as those emitted from an MRI machine and MRI’s aren’t now are they?

Approximately 3,000 low frequency magnetic pulses are delivered over 37.5 minutes. These magnetic pulses stimulate the prefrontal cortex and in turn stimulate the cortex neurons. It is the prevailing theory that depression is caused by an imbalance of the neurotransmitters in the brain specifically not enough Dopamine and fluxuations in Seratonin and Norepinephrine.  It is believed that this magnetic stimulation can help the brain increase production of Dopamine and balance out the Seratonin and Norepinephrine.

Okay enough medical gobbley gook!  Yes I can hear you jumping for joy and clapping your hands as if you’ve won the lottery!!

In simple laymen’s all this gobbleygoop is actually quite easy to understand.  Very weak electrical currents are passed through a fairly small magnet placed on left side of forehead near the ear.  It is believed that this is what takes place in the brain

1)   Increases the brain cells (neurons) potential for action.

2)   It targets the frontal lobe (prefrontal

lobe of cerebral cortex) pretty much

your forehead, which is widely believed

to be the brain’s emotion modulator.

3)   It targets the area of the brain that

controls Dopamine, Seratonin and

Norepinephrine, the chemicals

(neurotransmitters) that control

mood and thoughts.

This is still considered a very controversial treatment and not all in the psychiatric field are in agreement. It’s been used in Canada, Australia and Europe. The FDA in the United States approved it in 2008 and Neuronetics, Inc’s NeuroStar is the only device approved for use.

However, over 800 Doctors in 200 clinics in the U.S. are using it.  They say they love it and their patients seem very happy with the result.  The device itself costs $60,000 it’s a dentist office like chair with all the components with an electrical panel on the chair.  I could not find any information on cost per treatment, but as it is still in testing and research mode I seriously doubt that any insurance companies are paying for it yet.

There are some drawbacks to this treatment.  Its complete efficacy has not yet been proven and the results don’t last nearly as long as those of ECT.  Patients often have to return for more treatments.  Each treatment is 40 minutes per day, 5 days a week for 4 to 6 weeks.

Right now the criteria is quite strict.  Only patients who have been on one antidepressant without desirable effects are considered for this treatment.  Doctors and researchers are vigorously campaigning to have this changed so that all patients can benefit from this treatment.

As with anything there are always going to be side effects and adverse reactions.  This treatment has very few. People have complained of headaches and tenderness at site where the magnet is placed.  There is a very rare risk of seizure

However, studies have shown that close to 50% of those who did have a seizure already had a seizure disorder or had a family history of seizure disorder.

I realize this a great deal of information to digest.

The subject matter was complicated and I wanted to give

you an informed and comprehensive answer.

I sincerely hope this answered your question


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