TMS Treatment - Transcranial Magnetic Stimulation
TMS treatment in Gold Coast: MRI-guided, neuronavigated repetitive Transcranial Magnetic Stimulation therapy (nrTMS or nTMS).
Internationally and in Australia, TMS has been approved to treat a variety of conditions such as depression, anxiety and chronic pain.
MAGNETIC BRAIN STIMULATION THERAPY
What is TMS treatment?
‘TMS’ stands for Transcranial Magnetic Stimulation. TMS therapy is a non-invasive treatment that uses magnets to stimulate specific brain areas in its field. A non-invasive magnetic device is placed near the head during TMS treatment, which induces an electrical current in the underlying brain areas. This stimulates the brain to “reset” its activity in this area. Research has shown that TMS has an effect on neuroendocrinological processes, neurotransmitter systems, and neurotrophic factors (Pogarell 2006, 2007 and Baeken 2010) and connectivity between different brain areas (Paus, 2001 and Shajahan, 2002). It’s thought that imbalances in neurotransmitters are the cause of a number of mental health conditions.
About TMS Therapy
How does TMS work
During (Transcranial Magnetic Stimulation) TMS treatment, directed magnetic fields pass safely through your skull and stimulate nerve cells in targeted areas of the brain. This stimulation can help brain cells communicate better with each other to improve mood and reduce symptoms of depression or anxiety.
- TMS treatment can work alongside other therapies you may be undergoing.
- We use your brain scans to make sure TMS therapy targets the right areas (MRIs to personalise treatment). Think of it like driving with GPS.
- TMS is a non-invasive treatment as no surgery is needed.
TMS can offer new hope if you’ve been feeling stuck with depression or anxiety with depression. If you’re struggling with migraines or chronic pain, magnetic brain stimulation therapy is one more tool that may help you feel better.
TMS EFFICACY
Benefits of TMS Treatment
TMS therapy is a non-invasive treatment and can be done as an outpatient, meaning it is convenient and flexible around your schedule.
TMS is safe with none of the side effects of antidepressant medications (eg weight gain, sexual side effects) or ECT (memory loss) and very few side effects overall.
TMS is painless (you feel a gentle tapping on your head during the treatment).
It is scientifically proven and doctor prescribed treatment – only proven effective protocols are used.
TMS therapy is a natural treatment that stimulates the brain to make changes on its own.
And now in Australia, TMS treatment is Medicare subsidised, meaning it is more accessible for people who qualify!
Conditions We Treat
Clinical Depression
Depression is a common mental health condition characterised by persistent low mood, lack of interest in activities, and feelings of hopelessness. TMS has been shown to stimulate under-active areas of the brain involved in mood regulation, offering a non-invasive treatment option for individuals with depression, particularly those who have not responded to traditional therapies.
Anxiety with Depression
Anxiety often co-occurs with depression, leading to feelings of excessive worry, tension, and fatigue, alongside depressive symptoms. TMS targets neural circuits associated with both mood and anxiety regulation, potentially improving symptoms of both conditions by enhancing neural activity in specific brain regions.
Chronic Neuropathic Pain
Neuropathic pain results from damage or dysfunction in the nervous system, often causing chronic pain sensations. TMS may provide relief by modulating pain pathways in the brain, helping to alleviate chronic neuropathic pain in some individuals by influencing neural activity linked to pain perception.
Migraines (Acute and Chronic)
Migraines are severe headaches that may be accompanied by nausea, sensitivity to light, and other neurological symptoms. For both acute and chronic migraines, TMS can disrupt abnormal brain activity that triggers migraines, offering potential relief by reducing the frequency and intensity of migraine episodes.
Learn More
FAQ about TMS
- At the basic level, our brains communicate via electric currents. TMS uses the principles of electromagnetic induction to non invasively and painlessly introduce electric currents into specific brain areas to produce changes such as improved connectivity, regulation of neurotransmitters.
- Our brains are neuroplastic meaning that they are able to change (for example functionally, structurally) and this gives us an opportunity to treat some brain conditions by inducing these kinds of changes.
- The challenge of TMS therapy relates to the accurate targeting of brain regions associated with patent symptoms.
- Different kinds/forms of TMS have been used for a variety of brain applications such as mapping of brain areas (such as in research and brain surgery) and to examine the connections between different regions of the brain.
- rTMS (repetitive TMS) is the form that is used clinically to treat conditions such as depression and OCD, and it is called ‘repetitive’ because it uses multiple magnetic pulses in a treatment and people also need to have a number of treatments to have a clinical effect.
- This therapeutic effect occurs over time and is rarely experienced instantly.
- rTMS was first approved by the FDA for treatment of Major Depressive Disorder in 2008.
- Since then, rTMS has been approved by the FDA for refractory OCD (in 2018), smoking cessation (in 2020) and depression with anxious features (in 2022). There is a lot of ongoing research into other uses for rTMS.
- Since it was first approved for depression in 2008, there have been a multitude of studies which have scientifically proven that rTMS is an EFFECTIVE treatment for depression, with response (some reduction in symptoms) rates of over 53% and remission (no more symptoms) of over 27%.
- These results are very good when compared to antidepressant meds (38% response rate and 18% remission rate)
- In Australia, rTMS has been approved on the PBS as a treatment for treatment resistant depression since Nov 2021. This means that Medicare pays a subsidy for this treatment for people who have qualified for treatment.
- Neuronavigated TMS (nTMS) is a newer approach of rTMS that uses a navigation system to precisely target specific brain areas with TMS. Click here to watch a video of this in action: https://www.youtube.com/watch?v=T7JdMFBkBTo (source: Nexstim. 2020)
- Think of our navigated system akin to driving a car with GPS in the dark. Every brain shape is different and the current estimates of systems without neuronavigation (eg “skull cap” or “5cm rule”) can lead to an accuracy rate of 30pc (Herwig et al, 2001)
- To do this, we need an MRI. This will allow us to map what we can visualise of the brain’s surface.
- Since rTMS is a treatment that needs to be done repetitively over a number of weeks, it is important to be accurate with the treatment and targeting of the same specific brain region each and every time
- Thus, we use the most accurate rTMS machine on the market, NEXSTIM. To read their patient information booklet, please click here.
- We refer our patients to obtain a basic brain Magnetic Resonance Imaging (MRI) scan, which shows us exactly where to target. This MRI scan is uploaded into our Nexstim system. Nexstim uses SmartFocus 3D neuro-navigational mapping technology to ensure that each time you have your rTMS treatment, it is targeted to the specific area required.
- This combines something they refer to as ‘E-field’ visualisation, which shows exactly where and exactly how the brain is being stimulated subject to your own individual anatomy. Nexstim makes zero assumptions about targeting the right area, and delivering the right amount of therapy, and ensures that the amount of therapy is individually designed for each session.
- This is because the brain’s resting state changes from day to day. We ensure that our patients have rTMS treatment in the exact brain area, with the same therapeutic dosage, every time.
- We make zero assumptions about your brain anatomy and brain health, and explore each patient and each session individually to ensure the greatest clinical effect.
- Nexstim TMS machines have been produced for over 20 years and are used for a variety of purposes, including research and neurosurgery.
- Nexstim is the only company in the world to have their TMS machines FDA and CE approved for motor mapping (2009) and speech mapping (2012) which are important aspects of neurosurgical planning. This shows how anatomically accurate Nextstim is, which we hope will translate to more effective clinical effectiveness for our patients.
- In recent data using Nexstim; Of the first 403 patients completing treatment at clinical sites in the U.S., 200 (49.6%) had achieved clinical remission and 307 (76.2%) had obtained a clinical response at end of treatment based on Beck’s Depression Inventory (BDI) and Patient Health Questionnaire – 9 (PHQ-9) scores[1]. These are higher than what is consistently reported for non-navigated TMS.
Neuronavigated TMS (nTMS) is a newer approach to rTMS that uses a navigation system to precisely target specific brain areas with TMS.
Improved accuracy: nTMS uses a 3D navigation system to accurately locate and target specific areas of the brain. This results in more precise stimulation and fewer errors in the targeting of brain regions. This means that nTMS can be used to stimulate smaller or deeper brain areas that are difficult to access with traditional TMS.
Customization: With nTMS, the stimulation can be customized to the individual patient’s brain anatomy. This allows the stimulation to be tailored to the specific needs of the patient and increases the effectiveness of the treatment.
Higher treatment efficacy: Due to the increased accuracy and customization, nTMS can provide a higher level of efficacy compared to normal TMS. This is especially true in cases where patients have failed to respond to traditional TMS, as nTMS can target the specific area of the brain responsible for the patient’s symptoms.
Reduced side effects: The improved accuracy of nTMS means that there is less chance of stimulating unintended areas of the brain. This reduces the risk of side effects and makes nTMS a safer and more tolerable treatment option.
Increased patient comfort: The navigation system used in nTMS ensures that the TMS coil is positioned more accurately, reducing the need for repeated coil adjustments during the treatment. This results in less discomfort and increased patient comfort during the treatment.