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Transcranial Magnetic Stimulation (TMS)

What is Transcranial Magnetic Stimulation (TMS)?

TMS is a non-invasive brain stimulation treatment for patients with psychiatric or neurological disorders whose symptoms have not improved with routine care. The United States Food and Drug Administration (FDA) cleared TMS for treatment-resistant depression in 2008. Since then, the FDA has also cleared TMS for obsessive-compulsive disorder (OCD), migraine headaches, smoking addiction, and brain mapping before neurosurgery. The FDA has also granted TMS a breakthrough device designation for bipolar depression, but it has not yet cleared it for this indication.This page will focus on treatment-resistant depression, but feel free to contact us for more information about other disorders.

Why should I consider TMS?

Depression is among the leading causes of disability worldwide. Two out of three people taking antidepressant medications continue to experience symptoms of depression. Moreover, studies have shown that the probability of achieving complete symptom relief decreases with each new medication trial. TMS is a safe and effective treatment that can work even after psychotherapy and medications have not worked. Many patients consider TMS before esketamine or electroconvulsive therapy (ECT) because TMS does not require anesthesia, medication, or invasive procedures. TMS also has fewer side effects than esketamine or ECT, and patients can drive themselves to and from treatment.

How does TMS work?

TMS uses an electromagnetic coil to create magnetic pulses (similar to an MRI), which pass through the skull to stimulate the brain network involved in regulating mood. As such, it is generally not recommended for patients with seizure disorders or patients who have metal in the head area. Daily (weekday) treatment sessions for 4-6 weeks are typically required. During treatment sessions, patients recline in a chair while a TMS coil rests on the specific part of their head. The TMS coil makes a clicking sound and produces a tapping sensation when it is stimulating the brain. Patients are awake for the entirety of the session, which ranges from 3 to 37 minutes depending on the treatment protocol prescribed. Studies have shown that the antidepressant effects of TMS can last months or years after the acute series of treatments ends.

What are the common side effects of TMS?

Minor headache and lightheadedness are common side effects. A seizure is the most serious potential side effect associated with TMS. Studies have shown that TMS seizures are very rare, and most of them occur in patients who had identifiable risk factors for having a seizure. In fact, recent studies have shown that TMS is comparable to some antidepressant medications in terms of seizure risk.

Does insurance cover TMS?

Most insurance plans cover TMS after 2-4 antidepressant medication trials of adequate dose and duration.

Why choose the TMS Clinic at Brigham and Women’s Hospital?

  • Interdisciplinary team of neurologists and psychiatrists who are leaders in TMS, brain stimulation, and interventional psychiatry
  • Part of an innovative Center for Brain Circuit Therapeutics in the Hale Building for Transformative Medicine
  • Access to TMS clinical trials
  • Insurance authorization handled by administrative staff
  • Subsidized parking
  • Optimized to reduce exposure to the virus that causes COVID-19:
    • Remote consultations with new and established patients
    • Video monitoring during treatment
    • FDA-cleared TMS-Cobot, a robotic system that uses optical tracking or MRI neuronavigation to improve TMS precision and reduce exposure
    • Theta-burst stimulation, a treatment protocol that reduces treatment time without compromising treatment effectiveness

How do I schedule an appointment or refer a patient?

All patients must have a referring clinician, preferably someone with expertise in psychiatry. Referral methods are listed below:

For more information: Click for brochure, email, call 617-278-5598, or fax 617-525-0510.


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