NeuroStar® TMS Therapy is being studied as a possible treatment for depression.
Q: What is TMS Therapy?
A: TMS stands for transcranial magnetic stimulation. It is an innovative way to potentially treat depression by stimulating the brain with a non- invasive medical device. During TMS Therapy, a magnetic field is administered in very short pulses (microseconds in length) to the patient's head. These brief magnetic fields non-invasively stimulate areas of the brain that research has demonstrated to be associated with the development of depression. During a single session, about 3,000 magnetic pulses are given over an interval of about 30 minutes. Multiple sessions of TMS Therapy are usually given over several weeks.
Q: Is another therapy for treating depression really needed?
A: Depression is one of the most common and debilitating of all human diseases. A recent international study underscored this fact by noting that, when calculated in terms of disease burden, depression will be the 2nd most important source of disability of all human diseases by the year 2020. Despite major advances in our understanding of this illness and its treatment, depression remains a potentially lethal medical disease in its most severe form, with suicide as the most common cause of death in this condition. It is also increasingly appreciated that depression leads to an accelerated deterioration in the course of other concurrent medical disorders such as heart disease or diabetes. Even with the improved treatments developed over the past several years, the path to recovery can be daunting for patients:
- After their first trial with antidepressants, only about 30 percent of patients see a full resolution of their symptoms.
- Even after taking several different types of antidepressants, approximately 25 percent of patients remain chronically depressed and inadequately served by available treatments.
- Because antidepressant medications must be taken on a chronic basis, side effects of these treatments may be persistent and bothersome. Among the more common side effects are sexual dysfunction, weight gain, gastrointestinal and sleep disturbances. In clinical trials, 15 percent or more of all patients discontinue their medication use because of the associated side effects.
- If proven effective, TMS Therapy could be an important and novel option for patients who have had an inadequate response and or are intolerant to currently available antidepressant treatments.
Q: Is TMS Therapy new?
A: TMS Therapy is based on knowledge of physical principles dating back nearly 175 years. In 1831, Michael Faraday discovered that electrical currents could be converted into magnetic fields. That basic discovery has been applied to create a powerful and focused electromagnet that can stimulate the brain. During TMS Therapy, an electromagnetic coil that is placed on the scalp produces a pulsed magnetic field. The magnetic field passes non-invasively into the brain and induces an electric field that stimulates the nerve cells in the brain.
- Since the 1980s, TMS Therapy has been used in humans to study the nerve fibers that carry information about movements from the brain cortex to the spinal cord and the muscles.
- In the late 1990s physicians began to explore the therapeutic potential of TMS Therapy for the treatment of a variety of diseases, with depression being the most thoroughly studied to date.
- More than 20 randomized, controlled trials of TMS Therapy as a treatment for depression have been published by investigators around the world.
Q: How does TMS Therapy work?
A: Short pulses of magnetic energy produced by the NeuroStar TMS System are aimed at the left, front portion of the brain, an area of the brain that has been demonstrated to function abnormally in patients with depression. The magnetic field passes through the skull and into the brain easily. Inside the brain, the magnetic pulses produce an electric field. The resulting electric field stimulates the neurons in this region and results in changes in other brain regions that are thought to be beneficial in the treatment of depression.
Q: Does the patient experience any pain during TMS Therapy?
A: In general, TMS Therapy sessions are very well tolerated and are usually given in an outpatient setting with the patient comfortably seated in a chair, awake and alert. Most patients can feel a tapping sensation on the surface of their head as the magnetic pulses occur, and about some individuals may experience a slight headache for a short period of time after the procedure. In studies completed to date, there have been very few patients who discontinue TMS Therapy because of side effects.
Q: Aren't magnets already used to treat some illness?
A: TMS Therapy involves a unique method of using pulsed magnetic fields for potential therapeutic benefit. The intensity of the magnetic field is similar to the powerful magnetic fields used in magnetic resonance imaging, or MRI. These techniques differ radically from the popular use of low intensity, static magnetic fields. These products deliver weak and undirected static fields that are not capable of exciting brain cells.
Q: Is TMS Therapy like electroshock therapy?
A: Absolutely not. The two procedures are very different. ""Shock therapy," or electroconvulsive therapy (ECT), intentionally causes a seizure. TMS Therapy does not. Patients receiving ECT must be sedated with general anesthesia and paralyzed with muscle relaxants. In contrast, during the TMS Therapy procedure, the patient sits in a chair and is awake and alert throughout the entire 45-minute procedure. No sedation is used with TMS Therapy. Recovery from an ECT treatment session occurs slowly, and patients are usually closely monitored for minutes or a few hours after a treatment. Short-term confusion and memory loss are common, and long-term disruptions in memory have been shown to occur and may persist indefinitely in some people. In studies completed to date, TMS Therapy appears to have no negative effects on memory function.
Q: How long do the effects of TMS Therapy last?
A: Preliminary work has suggested that the effects of TMS Therapy persist beyond the acute course. The design of the NeuroStar TMS Therapy studies shed important light on the answer to this question. One segment of the study examined how well patients respond to TMS Therapy, comparing it with a sham. Patients who responded to the NeuroStar TMS System in this first segment can participate in a follow-up segment that will assess how long any positive effects last.
For more information about TMS Therapy and the NeuroStar TMS System, call Neuronetics, Inc. at 610-640-4202.
