TMS Treatment - Transcranial Magnetic Stimulation

we can bulk-bill you with Medicare if the indication for your rTMS treatment is Depression, so you will have no out-of-pocket costs.

Currently, not available in Australia, SAINT protocol is specific to the Magnus Medical system, and is not applicable to the neuronavigated rTMS systems used at Brain Aid Clinics.

We offer a selection of highly targeted and personalised, MRI-guided neuronavigated rTMS and iTBS treatment, in both “regular” and “accelerated” formats. This allows for precise targeting of the dorsolateral prefrontal cortex (DLPFC), enhancing treatment accuracy and potentially improving patient outcomes compared to standard rTMS protocols without imaging guidance.

Our accelerated TMS protocol involves two to three sessions everyday for seven days. This intensive approach aligns with the latest research on high-dose neuromodulation and provides a time-efficient alternative for patients seeking rapid improvement.

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.

rTMS (repetitive Transcranial Magnetic Stimulation) is a well-established Medicare-approved treatment with substantial scientific backing for treating major depression when other treatments haven’t been effective. rTMS follows standardised protocols based on extensive clinical research.

MeRT (Magnetic e-Resonance Therapy) is marketed as a personalised version of rTMS. It claims to customise treatment by incorporating brainwave measurements (qEEG) and heart rhythm data (ECG). While based on similar technology to rTMS, MeRT’s specific protocols are often proprietary, and its approach lacks the same level of peer-reviewed research that supports standard rTMS. The main difference between rTMS and MeRT is that while rTMS has been thoroughly studied for specific conditions like depression, MeRT makes broader claims across many conditions with less scientific validation.

In some countries, including Australia, TMS has been approved for other conditions like obsessive-compulsive disorder (OCD), smoking cessation, and chronic pain.

Ongoing TMS clinical trials are also being conducted for conditions such as Alzheimer’s disease, Parkinson’s disease, anxiety, and post-traumatic stress disorder (PTSD). While TMS is often associated with depression treatment, it has shown promise in treating a range of neurological and psychiatric conditions.

At BAC, we see patients with depression, particularly treatment-resistant depression. These are patients who have been treated for depression with medication, but their symptoms haven’t improved.

• NB: nTMS stands for neuronavigational rTMS (repetitive TMS). nTMS uses repetitive pulses provided by the magnetic coil as part of its therapeutic benefits, and uses neuronavigation – like GPS for the brain – to locate where we should stimulate.
• We use a map of your brain (provided by an MRI and our technology) to locate the right area for stimulation. This is called neuronavigation.
• Please discuss with your GP or Psychiatrist and ask them to refer you to Human Health Clinics for rTMS. You can self-refer (see below). For your safety, you’ll also need to consult with our experienced psychiatrist and health professionals who specialise in rTMS (Repetitive Transcranial Magnetic Stimulation).
• To qualify for Medicare subsidised rTMS, you need to be over 18 yrs old, be diagnosed with Major Depressive Disorder and have tried 2 antidepressant medications and a psychological treatment without success.
• If you do NOT qualify under Medicare, please speak to us about other arrangements, such as NDIS, private payment or select health funds.
• Once we have your referral, our friendly, our highly trained staff will contact you to discuss whether rTMS is the best treatment for you and whether you have any conditions that are contraindicated. This is also an opportunity for you to ask any questions.
• We will then book an appointment with our consultant Psychiatrist to meet and answer any questions you have
  If you decide to proceed, we will provide you with a referral for a brain MRI (additional costs applies).
• Your MRI scan of your brain can be transferred to our clinic on a physical disc (CD) or via upload
• We will arrange for you to have a mapping session for rTMS.
• You will still see your usual doctors and BAC will communicate with you and them regarding your treatment.

• Yes, please fill out our Patient enquiry form below ⬇️ to get started.
• We’ll call you for a chat to see if rTMS and our other services at BAC are right for you. For your safety, you’ll also meet with our expert psychiatrist and team who know all about rTMS.
• We will arrange for you to have an MRI and mapping session for rTMS.
• You will still see your usual doctors and BAC will communicate with you and them regarding your treatment.

We do not see children (people under the age of 18), although we are able to refer you to services that may be able to assist you.

If you have a child for whom you are considering TMS in a clinically-regulated, but  investigational setting, this trial into TMS for Autism (in Australia) may be suitable for you. Every patient and every situation is unique and the trial coordinators will have their own criteria for eligibility. We do not offer this service at BAC.

• We offer telehealth and in-clinic services, with some services at Medicare or attracting an out-of-pocket fee (if you don’t meet the requirements for Medicare).
• Medicare requirements for repetitive transcranial stimulation are listed here on http://www.mbsonline.gov.au/, under “rTMS – Patient factsheet – 25 October 2021” (PDF).
• Our neuronavigated TMS machine, Nexstim, is the only machine of its kind available in Australia. To attain its accuracy, you will need an MRI of your brain, for which the radiology company will charge a fee (typically $240 – $350). BAC does not receive any part of this fee.
• If you’d like to request a callback to discuss making an appointment or whether you’d qualify for Medicare, or the out-of-pocket costs, please fill in the form below.

Every patient and every situation is unique: you (and your loved ones) will need to make a decision balancing the cost of an outpatient clinic against the alternative of hospital admission and in-patient treatment.

BAC offers an advanced technology (neuronavigational TMS) to provide higher accuracy in targeting, per latest research. This additional technology attracts additional fees. To read more about neuronavigational TMS, see:

• Caulfield, K. A., Fleischmann, H. H., Cox, C. E., Wolf, J. P., George, M. S., & McTeague, L. M. (2022). Neuronavigation maximizes accuracy and precision in TMS positioning: Evidence from 11,230 distance, angle, and electric field modeling measurements. Brain Stimulation, 15(5), 1192-1205. https://doi.org/10.1016/j.brs.2022.08.013
• Pieramico, G., Guidotti, R., Nieminen, A.E., D’Andrea, A., Basti, A., Souza, V.H., Nieminen, J.O., Lioumis, P., Ilmoniemi, R.J., Romani, G.L., Pizzella, V., & Marzetti, L. (2023). TMS-Induced Modulation of EEG Functional Connectivity Is Affected by the E-Field Orientation. Brain Sciences, 13(3), 418. https://doi.org/10.3390/brainsci13030418
• List of Nexstim whitepapers (Nexstim is the manufacturer of the TMS device we use at BAC).

Brain Aid Clinics  sees private or self-funded patients, so there will be an out-of-pocket for our services. In most cases, Treatment Resistant Depression will be covered by Medicare and DVA as long as a patient has failed 2 or more antidepressants due to inadequate responses or intolerable side effects. The relevant Medicare numbers for TMS are for Depression only (14217 – 14220) and have requirements. Other indications for TMS may be covered by DVA and Work Cover. Australia Defence Force personnel may also be covered under BUPA.

You can ask your GP to refer you for TMS, or you can see our Mental Health nurse practitioner if you don’t have a GP and/or a psychiatrist.

A nurse practitioner is a “registered nurse who has completed specific advanced nursing education and training in the diagnosis and management of medical conditions and holds endorsement as a nurse practitioner” (source). You can find out more about their qualifications and requirements here and what they can do, particularly in the context of mental health (see PDF). In summary, they can diagnose, order MRIs, prescribe medications and intervene when treatment is not working out (eg treatment-resistant depression).

Our mental health team consists of psychiatrists, GPs, nurse practitioners, nurses and doctors who all hold current Ahpra registration and appropriate qualifications.