Reading time – 11 minutes
Transcranial magnetic stimulation (TMS) is a non-surgical method of treating neurological disorders. The procedure is officially approved by the FDA for the treatment of depression and obsessive-compulsive disorder. Research is now underway around the world to help determine the efficacy of TMS for epilepsy, Alzheimer’s, autism, Parkinson’s, essential tremor and other diseases. In this article, you will learn what success doctors have achieved with TMS and how it improves patients’ lives. And at the end of the article, we will tell you which clinics treat diseases for which TMS has been officially approved.
Listen to the article:
HOW DOES TRANSCRANIAL MAGNETIC STIMULATION WORK AND WHY DO WE NEED IT?
Transcranial magnetic stimulation is a procedure during which a strong magnetic field affects neurons in the brain. Depending on the field’s strength, neuronal activity in these areas can increase or decrease.
When a group of neurons is simultaneously excited, a strong bond is formed between them. It helps a person recover lost functions.
When the neuronal activity is suppressed, the bonds between the neurons are destroyed. This way, the patient can be relieved of unpleasant symptoms.
Rhythmic TMS (rTMS) is most commonly used in the treatment of patients. It can produce pulses with different frequencies. Thus, it is possible to suppress and activate different parts of the brain at the same time using one device.
INDICATIONS AND CONTRAINDICATIONS FOR TRANSCRANIAL MAGNETIC STIMULATION
Magnetic pulse therapy is offered to patients after drug therapy has proven to be unhelpful. TMS may be prescribed to people who cannot undergo deep brain stimulation (DBS) due to health risks.
The procedure should not be performed on those who have metal implants in their body, such as a pacemaker. It is also not performed on patients with acute psychosis.
Diagnoses in which transcranial magnetic stimulation may be effective:
In this article, we will describe how these diseases are treated and which organizations have approved TMS procedures for these diagnoses. In addition to this list, TMS also shows success in reducing the symptoms of post-traumatic stress disorder (PTSD), aphasia, hyperactivity disorder, and attention deficit disorder (ADHD). Its efficacy and safety are also tested to improve patients after stroke and brain injury.
Diseases for which this procedure is possible vary from country to country. For example, in American clinics, depression and OCD can be treated with TMS. Clinics in Europe have permits for transcranial stimulation for a wider range of disorders. To find out which clinic has available treatment for your disease with, ask our coordinator doctor.
PARKINSON’S DISEASE TREATMENT WITH TMS
In Parkinson’s disease, the middle brain and basal ganglia lack a special substance – dopamine. Low dopamine levels cause tremors and muscle weakness. Medicines restore dopamine levels, but they have many unpleasant side effects.
Through rhythmic TMS, the pulse activates the motor cortex neurons. Dr Siebner’s clinical research in Copenhagen has proven that after 4 weeks of treatment, patients have improved gait, reduced tremor and improved well-being. This effect is achieved faster than when taking medication.
TREATMENT OF ESSENTIAL TREMOR BY TRANSCRANIAL MAGNETIC STIMULATION
Essential tremor is the second most common movement disorder in adults after restless leg syndrome. It is not life-threatening, but it prevents a person from fully resting and working.
In tremor, rhythmic transcranial magnetic stimulation is also used to activate the motor cortex and cerebellum. Patients have a marked decrease in hand tremor after the first session. The procedure does not cause drowsiness or retardation like medication sometimes does.
TREATMENT OF DEPRESSION WITH TMS
TMS is used to treat depression in people who are resistant to antidepressants or other treatment alternatives. The main advantage of this procedure is that it does not lead to general lethargy, nervousness, nightmares, diarrhoea or nausea, which often occurs after taking antidepressants.
Patients with depression usually have 5 sessions per week for 1.5-2 months. One session takes 5 to 30 minutes, depending on the type of device. The procedure does not require hospitalisation – after a course of TMS, the person can return to their daily activities.
After magnetic stimulation sessions, depression symptoms completely disappearin ⅓ of the patients. About 60% report improved well-being. rTMS effects persist for 10-12 months. When symptoms return, the course should be repeated.
In 2008, the FDA approved the rTMS method for treating major depression.
BIPOLAR DISORDER TREATMENT WITH TRANSCRANIAL MAGNETIC STIMULATION
Every year more than 7 million people are diagnosed with bipolar disorder. Of these, 480,000 are resistant to pharmacotherapy. Magnetic field therapy can help solve this problem.
In 2020, the FDA began testing the use of TMS to treat manic states in adults who have not benefited from medication therapy. To stabilize the emotional background, doctors activate neurons in the patients’ frontal lobes.
Currently, the treatment of mood disorder with TMS is approved by CE and ANIVISA.
TREATMENT OF OCD WITH TRANSCRANIAL MAGNETIC STIMULATION
Obsessive-compulsive disorder is a chronic condition in which a person suffers from obsessive thoughts or repeats the same actions. However, he or she cannot consciously stop it. This diagnosis is found in 1% of people.
Transcranial magnetic stimulation alleviates these symptoms. Approximately 38% of people who received OCD therapy with TMS confirmed improvement. Their results on the Yale-Brown obsessive-compulsive scale declined significantly. Among adverse reactions, the headache was the most common.
OCD therapy with TMS was approved by the FDA in 2018.
TREATMENT OF CHRONIC PAIN WITH TRANSCRANIAL MAGNETIC STIMULATION
Transcranial stimulation may alleviate pain in diabetic neuropathy, migraine and after brain injury. Studies from European and Israeli clinics have shown that rhythmic TMS is particularly effective for pain relief in trigeminal neuralgia.
Chronic pain therapy is possible by activating those areas of the brain that can supply the perception of pain. Patients who underwent a 5-week course of stimulation showed significant symptom relief on the visual analogue scale (VAS) and an increase in the threshold of the RIII pain reflex. The results of treatment remained after a 3-week break from treatment.
In 2013, the FDA praised the potential of TMS to treat chronic headaches. Official approval of the use of rTMS for pain treatment will bring relief to millions of patients around the world.
TMS TREATMENT FOR AUTISM
During treatment, doctors stimulate the prefrontal cortex. It contains mirror neurons – a special type of cells that allows people to understand each other’s mood, sympathize and show empathy.
TMS improves the condition of children with low functioning autism (Kanner syndrome) and with high functioning autism (Asperger’s syndrome). After 10 sessions their MRI shows positive shifts in the activation of mirror neurons.
After the procedure, children begin to better understand non-verbal signals, they improve their social skills. They show less anxiety when communicating with other people, and the manifestation of repetitive monotonous movements is reduced.
TREATMENT OF ALZHEIMER’S DISEASE WITH TMS
Rhythmic TMS shows the greatest effectiveness along with cognitive training. In Alzheimer’s disease, magnetic pulses stimulate neurons in the temporal lobe, which is connected to the hippocampus, the brain part responsible for memory.
According to clinical studies, as a result of transcranial stimulation, the cognitive ability of the patient improves by 4 points. The effect lasts more than 5 months after treatment completion. Patients experience improvements in listening comprehension, explanation of actions and naming of objects.
In people with dementia at an early stage, doctors found significant improvements in cognitive function than in patients with dementia at an intermediate or late stage.
MULTIPLE SCLEROSIS TREATMENT BY TRANSCRANIAL MAGNETIC STIMULATION
Multiple sclerosis is a common autoimmune disease that affects the central nervous system. As of 2020, approximately 2.3 million people worldwide are affected by the disease.
Medication can only suppress certain symptoms. However, multiple sclerosis causes depression in 50% of patients. Depression increases the risk of suicide and prevents the person from investing in recovery.
The BrainsWay study showed that after a 6-week rTMS course the condition improved in patients with multiple sclerosis. Depressive symptoms became less pronounced, fatigue disappeared. TMS stimulation of the motor cortex also helped patients temporarily improve walking skills.
Therapy for depressive episodes in multiple sclerosis is CE approved.
EPILEPSY TREATMENT WITH TRANSCRANIAL MAGNETIC STIMULATION
In patients with generalized epilepsy, cortical excitability is increased. To reduce its activity, low-frequency rhythmic TMS is used.
According to statistics from American clinics, 80% of patients have a decline in seizure activity after a week’s course. Studies by the British organization Cochrane confirm that the risk of unwanted seizures in the treatment of epilepsy with magnetic impulses is very low.
In clinical studies, 8 out of 9 patients with myoclonic epilepsy had reduced the frequency and severity of attacks after rhythmic stimulation within 5 days.
SCHIZOPHRENIA TREATMENT WITH TRANSCRANIAL MAGNETIC STIMULATION
The main treatment of schizophrenia is antipsychotic drugs that eliminate positive symptoms: hallucinations, acute perception, delusions, etc. However, in schizophrenia people also suffer from negative symptoms: reduced mental performance, apathy, general lethargy. So far, the FDA has not approved any medication to treat the negative symptoms of schizophrenia.
Transcranial magnetic stimulation helps reduce the severity of negative symptoms of schizophrenia. For this purpose, neurons in the prefrontal cortex are reactivated using a magnetic field.
TMS also helps patients to get rid of auditory hallucinations. Neuroscientists have improved since the activity of neurons in the temporoparietal region decreased.
STROKE REHABILITATION WITH TRANSCRANIAL MAGNETIC STIMULATION
According to statistics from the World Health Organization, stroke affects 15 million people annually. One-third of them die, and the other third gain disability. Depending on what part of the brain is affected, a person may lose the ability to walk, talk, see, navigate in space, understand other people’s speech and so on. The application of rTMS in the rehabilitation of stroke patients will help restore some of these functions.
The results of the clinical trials are encouraging. High-frequency magnetic stimulation of the lower frontal lobe is effective for patients with post-stroke aphasia. After a few weeks of courses, patients re-learned to correctly name subjects.
Transcranial magnetic stimulation of motor cortical zones helps patients restore walking skills. After TMS courses, patients observed a significant increase in walking speed. After a 4-week break in treatment, patients’ results were not only maintained but also improved through regular physical training.
CE approved the restoration of patients after stroke with TMS.
WHICH CLINICS OFFER TRANSCRANIAL MAGNETIC STIMULATION?
For rTMS, you can refer to:
Deep depression and OCD can be treated in all clinics where TMS is available. Please check with our MediGlobus coordinators for treatment of other disorders in a particular clinic.
Stay with MediGlobus and keep up to date with the latest news on the latest developments in foreign medicine. If you need help from a neurologist abroad – leave an appointment. Our coordinators will help you find a clinic that offers a treatment program that will help you.
- 1. What is TMS
- 2. TMS to treat Parkinson’s disesase
- 3. TMS to treat tremor
- 4. TMS to treat epilepsy
- 5.TMS to treat autism
- 6. TMS to treat multiple sclerosis
- 7. TMS to treat mood disorder
- 8. TMS to treat schizophrenia
- 9. TMS to treat chronic pain
- 10. CE certification brainsway
- 11. FDA approval for OCD treatment