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Transcranial Magnetic Stimulation (TMS) is a non-invasive intervention for treatment-resistant depression. It is an excellent choice for people with depression who cannot tolerate the effects of antidepressant medication and are unresponsive to psychotherapy. Does TMS therapy really work? Yes, TMS is an effective form of treating treatment-resistant depression. Its efficacy in reducing symptoms of stubborn depression has spurred research in examining the potential of using it in treating other psychological disorders like Post-Traumatic Stress Disorder (PTSD), Obsessive Compulsive Disorder, and auditory hallucinations in patients with Schizophrenia.
TMS Therapy is not associated with any long-term side effects. Some common short-term side effects might include: lightheadedness, facial twitches, and discomfort at the simulation site, making it a tolerable treatment technique. Furthermore, seizures are rare with the use of TMS. The simulation affects the brain’s mood and maladaptive pathways. It activates the dormant parts of the brain involved in sustaining the depressive mood, easing the symptoms, and improving the patient’s mood. Symptoms decrease with each treatment session, enabling the patient to live depression-free for long periods of time..
How Does TMS Work?
To deliver the magnetic energy to the nerve cells in the brain, your doctor will place the device, which contains a magnetic coil, on your head. It’s placed to specifically target the prefrontal cortex and deliver magnetic pulses to some of the surrounding areas. The resulting electric current is what encourages the brain’s neurons to begin firing.
During this time, you might feel a gentle tapping or hear a clicking sound as the device delivers the magnetic pulses. Since TMS therapy is noninvasive, you’ll be able to relax in a chair, talk, read or watch TV during your session.
TMS is non-invasive – it does not use electrodes, is not administered through intravenous lines, or requires anesthesia. The procedure uses radio-magnetic pulses to stimulate neurons in the brain area responsible for mood regulation. An electromagnetic coil gets placed on the left of the brain’s prefrontal cortex. The magnetic field only affects about 2 to 3 centimeters of the brain region exposed to the treatment coil. Stimulated nerve pathways discharge neurotransmitters that counter the depressive mood and improve symptomatology.
How long does TMS therapy last? The treatment course depends on the type of electromagnetic coil used during treatment. Typically, patients get five sessions each week through a 4 to 6-week duration. All sessions last for about 30 minutes to 1 hour. Averagely, the patient goes for about 20 to 30 treatment sessions. Most patients get considerable depression symptom relief by the last week of the session.
Patients do not feel the electromagnetic pulses as it goes through the brain. The stimulation’s effect and the outcome become evident as the therapy sessions progress. The procedure’s side effects are mild and manageable.
How Effective is TMS Therapy?
There have been extensive studies on TMS therapy as an intervention for Major Depressive Disorder (MDD) that is unresponsive to psychotherapy and pharmacotherapy. Approximately 50% to 60% of patients with treatment-resistant depression find relief from TMS. A randomized control trial observing 307 patients on the efficacy of this procedure shows TMS has significant antidepressant effects. The participants also exhibited higher remission rates.
Although the effect of the intervention is not explicit at a biochemistry level, there is evidence that brain stimulation activates cerebral metabolic activities, which, in turn, improves depressive mood. In simple terms, studies show blood volume increase in the target brain region correlates to improved outcomes after treatment. Scientists measured brain blood flow volume before and after each treatment session to ascertain the results and impact of TMS.
Additionally, research shows TMS efficiency comes from its effect on neuron plasticity. The electromagnetic pulses augment activity at the nerve synapsis, increasing plasticity with the impact persisting long after treatment is over. Nerve cells become vulnerable to reorganization, making it easy to form pathways that enhance adaptive mood, emotional, and behavioral regulation.
Another plausible explanation for TMS’s efficacy is the connection between the left dorsolateral prefrontal cortex and the limbic system. The left dorsolateral prefrontal cortex is the area with mood dysregulation. The limbic system responds to emotional stimuli, reinforces the behavior, and works with the prefrontal cortex on goal orientation. Electromagnetic induction affects neuron pathways in these two regions, improving mood and behavior associated with depression.
TMS Effects and Impact Duration
How long do the effects of TMS last? The length of the symptom-free period varies between patients. For approximately one-third of patients with treatment-resistant depression, TMS permanently treats the mood disorder. Patients never experience depressive symptoms after treatment. However, for some patients, relief only lasts several months, long after the final session is over. The average length of the remission period is one year. Patients can get subsequent treatment rounds if the depression recurs.
TMS provides long-lasting relief compared to other antidepressant interventions for treatment-resistant depression. Its efficacy makes it the best option for combating persistent depression. Other solutions may not alleviate the symptoms of the mood disorder.
Therefore, TMS benefits individuals who found no relief with antidepressants and psychotherapy. It is also ideal for patients who cannot tolerate the side effects of depression medication or have health conditions limiting the use of pharmacotherapy. They get to experience prolonged remission periods after subsequent sessions of treatment with TMS.
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