Evaluating Transcranial Magnetic Stimulation Technologies: Deep vs. Traditional –

People with depression can live with symptoms for extended periods of time just before getting a therapy that functions. Failure about depression remedies can be a outcome of the drug-resistant nature of the depression itself, adverse side effects to medication or poor medication adherence. For patients who are unable to come across relief via pharmacology, there is nonetheless hope. Transcranial magnetic stimulation (TMS)¹ is a viable selection to either replace or couple with medication and is a noninvasive therapy that utilizes repeated magnetic pulses to safely and properly regulate neural activity connected to a variety of mental well being situations. This particular therapy has been shown to assistance men and women with therapy-resistant depression.²

There are at the moment two types of TMS obtainable as a type of therapy: 1) Traditional transcranial magnetic stimulation and 2) Deep transcranial magnetic stimulation, also recognized as Deep TMS. While they share specific similarities, each and every holds its personal exclusive attributes.

Behind the Technology: How Does TMS Work?

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TMS functions mainly because of Faraday’s law of induction,³ which describes the simple interaction in between magnetic fields and electric currents. The human body communicates via the central nervous technique, which utilizes electrical currents operating via neurons in the body to trigger muscle contractions and other activity. Magnetic fields can, if correctly directed and with suitable force, have an effect on neural activity in the brain by inducing an inverted electric existing, significantly like operating an actual existing on the surface of the brain. The outcome is a modify in the polarization of neurons in the impacted region of the brain, causing nerve cells to either turn into more excitable, or much less excitable.

Utilizing the exact same strength as an MRI (magnetic resonance imaging) machine, a magnetic coil is held more than the scalp, operating a field of magnetic power more than the scalp and into the brain. By targeting particular portions of the prefrontal cortex, TMS aims to decrease and even do away with depressive symptoms. However, some TMS technologies is restricted in its attain and efficacy. That is exactly where distinct types of TMS come into play.

Traditional TMS vs. Deep TMS: What’s the Difference?

Both Traditional TMS and Deep TMS have been shown to be protected, effectively-tolerated, and powerful solutions of treating depression. The variations in between the two include things like stimulation depth, coil variety, and the length of the session.

Depth and Targeting

Traditional TMS utilizes a figure-8 coil, whilst Deep TMS utilizes a patented H-coil held inside a padded helmet. While the magnetic pulses activated by Traditional TMS only attain a depth of .27” (.7cm), Deep TMS technologies manages to attain a important sub-threshold of 1.25” (3.2cm).⁴ Deep TMS also utilizes a drastically wider field of stimulation compared with that of Traditional TMS.

According to current research,⁵ Deep TMS is clinically-verified to safely stimulate deeper and wider ranges of the brain, specially therapy-resistant depression and therapy-resistant obsessive compulsive disorder (OCD).

FDA Clearance

Traditional TMS received FDA clearance to treat depression in 2008.  Deep TMS has received 3 FDA clearance indications. Its initial FDA clearance was for the therapy of depression in 2013,⁶ followed by FDA clearance for OCD in 2018.⁷ Deep TMS also became the initial TMS technique to get FDA clearance in the addiction space,⁸ for smoking addiction in 2020.

In addition to getting a clearance status from the FDA, Deep TMS also received the European CE (Conformité Européenne) certification mark for numerous other situations,⁹ indicating that Deep TMS was discovered to conform to the security, well being, and environmental requirements of items sold inside the European Economic Area (EEA). Deep TMS has received the European CE mark for a wide variety of mental well being and neurological situations which includes depression, OCD, Alzheimer’s illness, autism spectrum disorder (ASD), Bipolar disorder, Chronic Pain, Multiple Sclerosis (MS), Parkinson’s illness, Post-Stroke Rehabilitation, Post-traumatic tension disorder (PTSD), Negative Symptoms of Schizophrenia, and Smoking Addiction.

Effectiveness

As each and every therapy utilizes distinct gear and reaches distinct depths and widths of direct stimulation, Traditional TMS and Deep TMS have been shown to make distinct levels of effectiveness in treating a selection of patients and their symptoms. A study published in the Journal of Psychiatric Research showed that patients with moderate-to-extreme baseline depression accomplished drastically greater response prices¹⁰ when treated with Deep TMS and medication, when compared with Traditional TMS and medication, or medication alone.

The Importance of Identifying Differences in TMS

During a time when there are heightened situations of mental illness,¹¹ it is necessary to acutely realize option options such as TMS, and how each and every therapy can influence patient outcomes and experiences. In addition to providing patients the selection for a noninvasive therapy like TMS, it is also our duty to elevate education via each and every suggests probable so patients know not to drop hope when they come across themselves in an unsuccessful therapy cycle. Health is individual, and their therapy — even if it is TMS therapy — need to be produced individual as effectively.

Dr Rodriguez is the founder and healthcare director of the Delray Center for Healing in Delray Beach, Fla. The Delray Center utilizes an integrative wellness method, which includes person and group psychotherapy, transcranial magnetic stimulation, psychiatric medication management, as effectively as holistic components, such as workout therapy, acupuncture, massage, and nutritionist counseling. Dr. Rodriguez completed psychiatric instruction at the University of Miami, exactly where he served as Chief Resident.

References

1. Transcranial Magnetic Stimulation. Mayo Clinic. Assessed May 10, 2021. https://www.mayoclinic.org/tests-procedures/transcranial-magnetic-stimulation/about/pac-20384625
2. Can You Overcome Treatment-Resistant Depression? BrainsWay. Assessed May 10, 2021. https://www.brainsway.com/knowledge-center/overcome-treatment-resistant-depression/
3. Magnetic Flux, Induction, and Faraday’s Law. Physics Libre Texts. Updated November 5, 2020. Assessed May 10, 2021. https://phys.libretexts.org/Bookshelves/University_Physics/Book%3A_Physics_(Boundless)/22%3A_Induction_AC_Circuits_and_Electrical_Technologies/22.1%3A_Magnetic_Flux_Induction_and_Faradays_Law
4. Ginou A, Roth Y, Zangen A. Comparison of superficial TMS and deep TMS for significant depression. BrainsWay. Assessed May 10, 2021. https://www.brainsway.com/knowledge-center/comparison-of-superficial-tms-and-deep-tms-for-major-depression/
5. Cocchi L, Zalesky A, Nott Z, Whybird G, Fitzgerald PB, Breakspear M. Transcranial magnetic stimulation in obsessive-compulsive disorder: a focus on network mechanisms and state dependence. Neuroimage Clin. 2018 19: 661–674. doi:10.1016/j.nicl.2018.05.029
6. BrainsWay Receives FDA Clearance. BrainsWay. Published on the internet in 2013. Assessed May 10, 2021. https://www.brainsway.com/news_events/brainsway-receives-fda-clearance/
7. BrainsWay Receives First Ever FDA Clearance of a Non-Invasive Device for Treatment of Obsessive Compulsive Disorder. BrainsWay. Published on the internet August 19, 2018. Assessed May 10, 2021. https://www.brainsway.com/news_events/brainsway-receives-first-ever-fda-clearance-of-a-non-invasive-device-for-treatment-of-obsessive-compulsive-disorder/
8. BrainsWay Receives FDA Clearance for Smoking Addiction in Adults. BrainsWay. Published on the internet August 24, 2020. Assessed May 10, 2021. https://www.brainsway.com/news_events/brainsway-receives-fda-clearance-for-smoking-addiction-in-adults/
9. A Platform for Mental Health Treatment. BrainsWay. Assessed May 10, 2021.  https://www.brainsway.com/our-treatments/
10.  Filipčić I, Filipčić IS, Milovac Z, et al. Efficacy of repetitive transcranial magnetic stimulation using a figure-8-coil or an H1-Coil in treatment of major depressive disorder; A randomized clinical trial. J Psychiatr Res. 2019 Jul114:113-119. doi:10.1016/j.jpsychires.2019.04.020
11. Reinert M, Nguyen T, Fritze D. The State of Mental Health In America. Mental Health America. Published on the internet October 20, 2020. Assessed May 10, 2021. https://mhanational.org/issues/mental-health-america-printed-reports