Transcranial Magnetic Stimulation (TMS) is a non-invasive, FDA-approved treatment for depression. It uses magnetic pulses to stimulate a mood center of the brain, increasing activity in this area and providing lasting relief. Remarkably, it has been reliably shown to help people with treatment-resistant depression- those that have not found success from traditional therapies such as antidepressants. Here at South Shore NeuroPsychiatric Center, we have been using TMS to help our patients combat depression since 2010.
While there are several TMS devices on the market, we believe in choosing the most proven option for our patients. We use the NeuroStar device, which is backed by the largest clinical data set of any TMS treatment for depression. In fact, more than 2 million treatments using the NeuroStar device have been performed worldwide. NeuroStar TMS Therapy is proven effective for patients who have not benefited from prior antidepressant medication, and NeuroStar is the only TMS device to have demonstrated long-term durability of clinical effect over 12 months.
TMS PROCEDURE
Patients are fully awake and alert for the entirety of the short TMS procedure. The step-by-step process occurs as follows:
1. The patient is seated and the NeuroStar magnetic coil is carefully positioned over the patient’s head. 2. The TMS machine is set to the established treatment parameters. Once treatment begins, the pulsing is described as a light tapping against the scalp. 3. During the session, patients are free to relax, read, listen to music, or watch TV. The TMS technician remains in the room for the duration of the treatment. 4. After the session is concluded, patients are free to resume normal daily activity.
The NeuroStar TMS machine we use constantly monitors that the patient is in full contact with the magnetic coil. This is important because motion away from the coil can reduce the amount of pulses that actually reach the target area. By using NeuroStar technology, we ensure that each patient gets the prescribed dosage of magnetic pulses.
TREATMENT
How it Works
During a TMS session, a magnetic coil is carefully placed against a specific area of the scalp. The magnet then sends pulses (similar to an MRI machine) to activate a mood center of the brain that is underactive during depression. This stimulation increases the brain’s activity in that specific region and provides relief from depression.
Before the first TMS session, the patient’s brain is mapped using the NeuroStar device to precisely target the mood center. After this preliminary procedure, the treatment plan begins. Each therapy session takes about 40 minutes per established treatment protocol, and can be integrated into your daily schedule. Because the procedure is simple and non-invasive, after a session patients can return to work or continue with their everyday activities.
What to Expect
Initial Phone Call
If you are interested in TMS therapy, discussing your treatment options, or simply finding out more information, please contact us (make link), or call at 516-295-4867.
During this initial telephone conversation, we will gather some basic information and address any questions you may have regarding TMS therapy. At this time we will also set up an initial consultation with Dr. Fruitman. If you have questions about pricing or financing options, they can be discussed at this time or at the consultation in person.
Pre-Treatment Consultation
During this meeting you will meet with Dr. Fruitman and the rest of the staff here at South Shore Neuropsychiatric Center. We will discuss your medical and social histories, your treatments goals, and how we can best meet your needs. If it is determined that TMS therapy is the best treatment plan for you, we will schedule the first treatment appointment, and also discuss financing options.
Brain Mapping and First Treatment
This first appointment will consist of the brain mapping session followed by the first TMS treatment. Because we will perform both procedures, this initial appointment will take about 90 minutes.
During the mapping session, we will locate the left dorsolateral prefrontal cortex, the mood center of the brain that we will target throughout the course of treatment.
Treatment Plan
While the full treatment plan will be determined at the initial consultation, patients can expect for a full course of TMS treatment to last for 5-6 weeks. Patients will typically come in 5 days a week (Monday through Friday) for sessions of about 40 minutes.
Is TMS Covered by Insurance?
Almost all major private insurances authorize TMS. As an out-of-network provider, we’re able to negotiate single-case coverage for TMS with most private plans if the treatment is deemed medically necessary and patient meets clinical criteria.
If insurance coverage isn’t an option, we can also work with you to develop an out-of-pocket payment plan to cover the cost of treatment. Contact us to learn more.
Learn About the Science Behind TMS:
Treatment resistant major depression, defined as failure to respond to traditional medications and therapy, is a serious clinical issue. In order to address the illness through a different approach, Transcranial Magnetic Stimulation (TMS) directly targets the left dorsolateral prefrontal cortex. This area of the brain has been identified to be underactive in people with depression, and its dysfunction is associated with many of the behavioral symptoms seen in depression. These include decreased energy, changes in appetite, and disruption of the sleep cycle. The magnetic pulses emitted by the TMS machine stimulate the neurons in this region, which increases their activity and helps to reduce the symptoms of depression.
In multiple controlled studies, patients who have already failed several medication trials responded significantly better to TMS than to sham treatment. In a large clinical trial, the antidepressant remission rate dropped significantly with each failed medication, which suggests the need for an alternative therapy. As shown in the following chart, once a patient has failed three medication trials, TMS is almost three times as likely as a fourth medication to produce remission.
In a National Institute of Mental Health - funded study, patients treated with NeuroStar TMS were four times more likely to achieve remission from depression compared to patients given a placebo.
