Treating Medication Resistant Depression With TMS

Can Medication Resistant Depression be Solved with TMS?

Struggling with depression can make life painful, dull and disheartening. If you have ever had to deal with the pain of different anti-depression medication not working or carrying heavy side-effects with it, the experience is all too familiar.

Transcranial Magnetic Stimulation offers a chance out of this cycle for many that couldn’t find relief through other means.

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7 Practical Actions You Can Take to Supplement Your TMS Treatment

Choosing to seek treatment for chronic depression can be difficult. We hope that seeking treatment can be something to be celebrated. When depressed, it is challenging to feel any glimmer of hope, even for Transcranial Magnetic Stimulation. However, like so many, you can truly find relief from your depression symptoms by undergoing this cutting-edge treatment. While TMS has offered excellent results for countless chronically depressed patients, results can be even more dramatic when combined with other depression management techniques. If you’ve decided to move forward with TMS treatment, consider also participating in one or more of the following self-care methods to further improve your health.

Reconsider Your Diet

The Standard American Diet (SAD) that most of us eat can create insulin spikes in the blood that make it very difficult to maintain a balanced mood. The constant roller coaster of blood sugar surges and crashes, which are the result of eating processed food laden with sugar and other additives, can wreak havoc on your depression. Many depression sufferers have found mild to moderate relief from depression symptoms by moving towards a whole food, plant-based diet, or low carbohydrate diet. Consider meeting with a dietician or nutritionist who can help you find the eating plan that best fits your needs.

Get Active!

Living an active lifestyle increases the number of endorphins, or feel-good chemicals, in the brain. Try exploring many different activities- walking, spinning, swimming, surfing, skateboarding, biking, yoga or dance classes- to discover what you enjoy the most. Even simple methods for increasing activity, such as wearing a pedometer to encourage more steps each day and avoiding the elevator by taking the stairs, can make a huge difference in both your physical and mental health. If you live a mostly sedentary lifestyle, take small steps to be more active, in a fun, non-pressured way, so that engaging in activity feels joyful rather than stressful or burdensome.

Reconnect With Nature

Making an intentional effort to get outside each day also benefits mood. Fresh air and sunlight help you to get the Vitamin D you need to stay healthy and well. In fact, a lack of Vitamin D is associated with depression. Additionally, natural sunlight helps regulate circadian rhythms to improve sleep and restore healthy sleep cycles. Supporting a natural sleep cycle and sleep hormones help you relax with less effort and manage symptoms of depression better.

Find Support

Depression can be isolating. You may often feel too overwhelmed or exhausted to reach out to friends, family members, or other loved ones. Connecting with people who know and love you, however, can help you feel a lot better. Reminding yourself that you are connected to others and are an essential part of the world can help you remain motivated to continue treatment for depression and to avoid feelings of apathy and thoughts of suicide.

Connecting with a mental health professional by committing to therapy with a counselor, rabbi or minister, is also a valuable adjunct to rTMS. A trained professional will help you process your thoughts and emotions and will provide effective tools and coping mechanisms to deal with stress and depression. Remember that you are allowed to choose the mental health supports that feel best to you. Meeting with several different counselors to find the ideal fit is always a good idea. Feel free to shop around and choose the professional who matches your needs for mental health support.

Commit to the Basics

Depression can make even simple tasks, like bathing and getting dressed, exceedingly difficult. Even if you don’t plan to leave your home, be sure to get up and get yourself ready for the day. Not only will you be more likely to be productive, but you’ll be able to experience the satisfaction that comes along with checking something off of your list for the day. If you feel that bathing and dressing are impossible, start with small steps, such as brushing your teeth and washing your face. Over time, you’ll remember the comfort and positivity that comes with caring for yourself and feel ready to add even more self-care items to your regimen.

Cut Down on Technology

It is becoming more and more apparent that excessive screen time is detrimental to mental and physical well-being. Try to limit cell phone, iPad and computer time and curb your exposure to social media and television. Recent studies have proven that cutting down on social media can help reverse effects of depression. Spending less time in front of the TV will encourage you to explore hobbies, both new and old, as well as help you to be more active and imbue more meaning into your life. Less screen time, especially at night, helps you to relax easier and sleep better.

Be Patient

Managing symptoms of chronic depression is a lifelong endeavor. You may have several months of success where you are caring for yourself and feeling optimistic about the future, followed by weeks when you can barely get out of bed. All of these experiences are a part of the process. Be sure to be kind to yourself, and don’t beat yourself up when your symptoms become more severe. With time, treatment and disease management skill building will allow you to live a consistent life largely unhindered by your depression.


Congratulations on choosing to seek treatment for your depression. While depression can be extremely challenging to manage, TMS treatment, along with other, intentional self-care methods, give you the best chance to live a life in remission, free of depressive symptoms and recurrences.




TMS: The Latest Advancements and More! 

TMS is by all accounts a pretty remarkable technology. It offers safe, effective, and drug-free relief from treatment-resistant forms of depression and anxiety. But as far as TMS technology has come in the past three decades, researchers and clinicians are continually looking to improve the treatment further! Academic and commercial research seems to be published almost constantly, documenting new applications and modifications of TMS devices and techniques. In this article, we want to lay out some of the latest advancements in TMS technology and detail the future directions of TMS.


Theta Burst Stimulation:


Theta Burst Stimulation is a relatively recent advancement in TMS technology that has been rapidly adopted by clinicians. The technique was first employed in European clinics, but has now made its way to the US. Just like conventional rTMS, theta burst therapy uses magnetic energy to stimulate the prefrontal cortex of the brain and improve depressive symptoms. The difference lies in how the stimulation is delivered. The Theta Burst protocol delivers stimuli in a unique pattern—three rapid bursts of pulses at 50 Hz, repeated every 200 ms. Compared to the conventional rTMS that uses a lower frequency, single pulses with inter-episode intervals. As a result, the treatment time is greatly reduced with Theta Bursts. Theta Burst Stimulation only takes 4 minutes, and research shows that it works equally well, if not better, than standard protocols that take upwards of 20 minutes.

Here at South Bay TMS we have begun to implement this protocol with great success. Our patients now have the option to receive both the Theta Burst and the conventional rTMS protocol in a single treatment—doubling the effective stimulation each patient receives. We believe that this, in part, is how come our patients have been so successful in achieving remission.


Multiple Magnets:


Current research is also underway to develop new TMS devices that use multiple magnetic coils. One such investigational device, now in clinical trials, is produced by the company Cerval Neurotech. The device utilizes a property referred to as spatial summation, where the magnitude of the multiple magnetic waves sum together. In theory, this property allows the new device to directly stimulate deeper structures in the brain and achieve higher circuit-level specificity in the brain. Although unpublished, the company reports that the pilot clinical trials to date have produced positive statistical and clinically relevant results.


Precision TMS with Structural MRI:


Incorrect placement of the magnetic coil on the patient’s cranium remains a common issue with TMS delivery. If the magnet is placed incorrectly, the target region of the brain will not be stimulated and no therapeutic effect will be observed. In current TMS protocols, coil placement is approximated using the relative location of the primary motor cortex, but a number of factors, including practitioner error and patient-specific anatomy, can lead to errors in this placement.

However, there are new TMS devices being developed, which incorporate sophisticated MRI-based navigation within their designs to enhance the precision of coil placement. These devices would eliminate these kinds of procedural errors, by effectively providing the physician with a detailed map of each patient’s brain.

TMS for Alzheimer’s

Treating Alzheimer’s with TMS Therapy

Alzheimer’s is a chronic neurodegenerative brain disorder that affects more than 46 million individuals globally. The cause and mechanism of the disorder are still not fully understood, but it appears that certain genetic factors and past brain trauma put individuals at a higher risk. Typically, the progression of the disease occurs slowly over the course of many years. As Alzheimer’s progresses and more brain cells are lost, increasingly severe symptoms present, including loss of memory and decreased cognitive function. While treatments exist to lessen symptoms, at the moment, no treatments exist to stop or reverse the progression of Alzheimer’s. However, an exciting recent study suggests people with early Alzheimer’s disease could reap modest benefits from brain stimulation through rTMS.

Evidence for The Support

Earlier this year, at the 13th International Conference on Alzheimer’s and Parkinson’s Diseases in Vienna, the company Neuronix reported the results of its latest phase III clinical trial for the use of its TMS device, known as neuroAD, in Alzheimer’s patients. In this study, the company enrolled 130 individuals with mild to moderate Alzheimer’s at 10 sites—nine in the U.S. and one in Israel. About 80% of participants were already taking some form of symptom-relieving therapies. At the start of the trial, each person took a cognitive test to gauge mental function and was randomly assigned to receive the rTMS-cognitive therapy or a sham treatment for six weeks. The sessions lasted about an hour each day, five days per week. Patients retook these tests 6 and 12 weeks after beginning treatment. Results demonstrated that the active-TMS group showed a 1.8-point test score advantage over the sham group at the 12-week mark.
For reference, finding effective therapies for the treatment of Alzheimer’s disease is extremely difficult—historically less than 1 percent of all Alzheimer’s drug trials have succeeded. For this reason, researchers were understandably excited when their results documented a statistically significant positive effect of TMS for cognition.

John-Paul Taylor, a neuropsychiatrist at Newcastle University in England, who was not involved with the study, agrees that these results are very exciting and that more research is required. He and his team are currently working on integrating computational modeling and neural imaging into TMS delivery. He believes that, in the near future, the results of these Alzheimer’s studies can be improved using his methods, suggesting that we might be able to tailor stimulation to each individual’s case for increased effectiveness.


Read about the 10 signs of Alzheimer’s Disease:

Read about the 7 stages of Alzheimer’s Disease:



The Benefits of Alternative Treatment for Depression

Thanks to transcranial stimulation (TMS), a great deal of attention has been brought to alternative treatment in neurology and psychiatry. Even though TMS is only currently FDA approved for depression, doctors have been intrigued by the fantastic results and started using it for other brain disorders like tinnitus, chronic pain, migraine, dementia, Parkinson's disease, and autism. The suggested and most effective area of the brain to perform TMS is the dorsolateral prefrontal cortex. Also, according to Frontiers in Neuroscience, published on December 2016, evidence shows that TMS has already made groundbreaking news in eating disorders. After using TMS, patients diagnosed with anorexia, bulimia, or binge eating have demonstrated effective results in reducing cravings.

The Benefits of Non-Invasive Treatment

The term non-invasive is used to describe a medical procedure that does not require cutting into the patient’s body. When going through surgery, a person’s body goes through nearly traumatic levels of stress, but the most important advantage of having a non-invasive procedure is reduced risk! Non-invasive treatments can be extremely convenient for patients. In addition to the patients’ effective results, they also benefit from one or more of the following:

  • Little to no pain
    • No need to worry about taking analgesics
  • Shorter to no recovery time
    • No downtime
    • You do not need to worry about taking time off from work (using up your vacation days), or someone to take care of you
    • After your simple procedure, you can return to your daily routine right away
    • No hospital stays
  • Reduced risks and side effects
    • You do not have to worry about the risk of infection or anesthesia complications
    • No need to worry about losing too much blood
  • No anxiety from going under the knife
    • Hence, no scarring

The Benefits of Non-Drug Treatment:

Non-drug practices are literally defined by their name because they do not necessarily utilize a prescription. Although we are not opposed to necessary medication regiments for chemically imbalanced patients, there are a lot of benefits to the fact that TMS is a non-drug treatment for depression. First and foremost, this allows TMS to be a supplement to a prescription. Supplementing a medication is always a good idea, and it’s typically done through lifestyle choices. For example, those who are struggling with anxiety are often encouraged to meditate and exercise, and those struggling with depression are often encouraged to revise their diet. Therefore, supplementing medication is a practice that is already happening, and the non-drug nature of TMS allows us to be able to supplement a prescription in order to achieve optimal results.

The Benefits of Non-Systemic Treatment:

A systemic treatment for depression is a treatment that affects the body as a whole. Medications are the most common form of systemic treatment for depression; since they are digested and circulated through the entire body, this classifies them as systemic, whether there are side effects or not.

A non-systemic treatment for depression is one that targets a specific area and only affects the part of the body that’s treated. TMS falls into this category because the magnets ONLY effect the part of the body that’s targeted, and they do not affect the system as a whole. TMS therapy targets a specific part of the brain, depending on the application, and through this only that part of the body is affected.

Non-systemic treatments are essentially considered alternative because the most common practice is to prescribe a medication regiment. Non-systemic treatments can supplement or replace systemic treatments, and depend on the circumstances at hand and the doctors involved those specific treatment variables will be considered on a person-by-person basis.

The Future of Alternative Treatment:

There has been an increased focus on the creation, implementation, and refinement of alternative treatments for depression and because of this, we believe that the future is bright for these options. We've seen the development and the support of alternative therapies increase in conjunction with the results that they've produced, so we project that there will be a considerable number of alternative supplements, and possible replacements, to a typical treatment regimen. 

It’s no secret that TMS is a fairly new FDA approved procedure. However, because of the amazing record of the clinical trials, doctors are getting to work. They are perfecting the most accurate cortical regions of the brain to find out where the TMS target is for each neurological condition. We believe that TMS is on its way to being the most effective alternative procedure of all time. We recognize that treating depression is a daunting task and its why we encourage the use of alternative therapy platforms here at South Bay TMS that supplement typical medicated approaches in order to help an individual achieve the most optimal treatment. 

Further Reading:

Top 5 Off-Label Uses for TMS

TMS is an FDA Approved Treatment for Depression

For more than 20 years, researchers have been studying TMS as a potential therapy for many neurological and psychiatric conditions. Today, the U.S. Food and Drug Administration (FDA) has cleared the use of TMS for the treatment of depression in adults who have been failed by antidepressants. FDA clearance for treating depression is a great guide that this treatment can help many patients suffering from other neurological and psychiatric conditions. There have already been a noteworthy amount of successful, carefully conducted clinical trials to show for it. For example, amazing research suggests that TMS can also help patients with symptoms of schizophrenia and improve movement rehabilitation after a stroke. However, it doesn’t yet have FDA clearance for these uses.

Heres The Top 5 off-label Uses for TMS:

Tinnitus Treatment

Tinnitus is described as a ringing or other phantom sounds in the ears or head. It is experienced by 10-15 percent of the adult population. Research shows that TMS therapy is a successful alternative for existing tinnitus therapies. It is probably shocking to read, but TMS has been successful in treating tinnitus because it is caused by malfunctioning pathological wiring in the brain. TMS focuses on the auditory regions of the brain. Expect TMS to be FDA approved for tinnitus in the near future, as it is one of the most studied off-label uses.

Stroke Recovery Treatment

About 750,000 people in the United States are affected each year by a stroke, making it the number one cause of disability for adults. Stroke was also the second leading cause of death worldwide in 2011 (6.2 million deaths). After several studies, TMS has been successful in treating patients right after they have had a stroke to activate areas of the brain that were damaged from the stroke. Following its success in stroke recovery, TMS has had positive attention in the health community and it will only continue.

PTSD Treatment

Post-traumatic stress disorder (PTSD) is described as a dangerous anxiety response to a life-threatening situation that is triggered by places or events that remind patients of the traumatic experience. TMS administers short pulses of a magnetic field, stimulating the inactive or disrupted area of the brain or suppressing the overactive area of the brain, reducing symptoms of anxiety and depression associated with PTSD. TMS has shown promising results in healing wounded brains by fixing the chemical imbalance in the brain.

Autism Treatment

Autism is a complex developmental disability that typically appears during the first three years of life and is the result of a neurological disorder that affects the normal functioning of the brain. According to the Centers for Diseases Control, 1 in 68 American children has some sort of Autism.  Autism Spectrum Disorder has seen a 3,000% increase in diagnoses in the last 30 years. Even though the research for TMS for the treatment of autism is still in its infancy, it is growing rapidly. TMS targets the part of the brain where there is an overactivity or over responsiveness in people with Autism. TMS can be paired up with a behavioral intervention when treating patients with Autism. After using TMS, patient John Robinson from Boston said he “gained a cognitive perspective that has greatly broadened his ability to read and recognize emotions.” Clinical trials have already suggested that TMS can help relieve autism symptoms like irritability and repetitive behaviors, along with improvements in eye-hand coordination and social skills.

Alzheimer’s Disease Treatment

Alzheimer’s Disease is described as a major cause of a severe cognitive decline in the elderly. The primary mental deficiencies are shown in working memory, language, executive functions, attention, and long-term memory. TMS has always been a great candidate to help relieve the symptoms that come with Alzheimer’s Disease. Celebrated studies have shown to have quick improvements in memory and cognition. In result, patients score higher points on the Alzheimer Disease Assessment Scale-Cognitive after undergoing TMS therapy.

Further Reading:

30 Plus Years of TMS: Where We Were and Where We’re Going

TMS (Transcranial Magnetic Stimulation) just celebrated a major anniversary this year—thirty years!  The device and technique was first described in academic literature just over three decades ago in a ground-breaking study by Dr. Anthony Barker, published in the Journal of Neuroscience! We at South Bay TMS thought we’d take this anniversary as an opportunity to look back on where TMS began and look forward to where it’s going next!

The Pre-history of TMS:

Let’s start way, way back in the 1700’s. It was then that great minds like Luigi Galvani laid the ground work for TMS, by beginning to explore the effects of electricity in the body. Basically, he started electrocuting frogs, and seeing what happened—that’s science for you. Anyway, in doing so, Galvani actually learned a lot and gave rise to the field of electrophysiology—the principles of which have given us everything from pacemakers, to EKGs, to (you guessed it) TMS!

Now, you might be wondering where the “electricity is in TMS”, given that the “M” stands for magnetic. That’s where Michael Faraday comes in. Faraday discovered in the 1800’s that an electric current could be induced by a magnetic field. This revolutionary discovery is ultimately the cornerstone of all TMS therapy. TMS differs from more invasive treatments like electroconvulsive therapy, because of this principle. In TMS therapy, a magnetic can be used to gently and painlessly induce electrical stimulation in neural circuitry the brain. This stimulation is ultimately what is responsible relieving patient’s depressive symptoms.

The Early Days of TMS:

Flash forward a century or two, and we finally get to the real deal: the development the TMS device. As we said before, this occurred thirty years ago in the mid 1980’s in large part to Anthony T. Barker. The TMS of the 1980’s looked a little different though.

For one, the devices were pretty rudimentary compared to modern-day equivalents—not much more than a coil connected to a big battery.

Secondly, the original devices were actually not designed for therapeutic use. In those early days, the devices were used primarily for diagnostic and research purposes. For example, in that first paper publish 30 years ago, the machine was simply used to probe the central nervous system. Around this time, other physicians began using TMS to diagnostically measure motor conduction time in patients with multiple sclerosis (MS).

However, even in those nascent years of TMS, there was hope it could one day be used for therapeutic ends. It just would take about a decade’s worth of research on TMS and the brain generally for this to become a reality.

TMS Therapy – 90’s to now:

It wasn’t until the mid 1990’s that the therapeutic application was of TMS was explored in depth. In 1995, Kolbinger et al. was the first team of researchers to study and publish on the use of TMS in the treatment of pharmaco-resistant depression. This double-blinded, placebo controlled study was relatively small in size with only 15 participants, but it showed enormously promising results and began what would become a torrent of academic and clinical research on the application of TMS for depression.   

Over the course of the next decade, dozens of larger studies were conducted validating the efficacy and safety of TMS therapy. Psychiatrists across the US and globally began implementing TMS in patients who’d did not respond to traditional treatment methods. Throughout the early 2000’s as evidence mounted, numerous internal governmental health agencies formally approved the TMS procedure. Health Canada, the Canadian equivalent of the FDA, for instance, approved TMS in 2002.

In the US, doctors continued to use TMS throughout the early and mid 2000’s as an off label treatment for depression with remarkably positive results. The historically-diligent (but occasionally slow) FDA lag a few years in its response. Then, finally in 2008, after completing a rigorous examination, the agency officially the approved therapy! In doing so the agency made it possible for the therapy to become more widely available and covered by insurance companies.

Now, almost 10 years later, use of TMS across the country is at record levels. The machine and treatment protocols have continued to be refine for optimal results, and TMS remains one of the most efficacious alternatives to drug-therapy.

The Future of TMS:

The future of TMS looks bright! Already clinicians and researchers in the past decade have been successfully using TMS off-label to treat a wide range of psychiatric and neurological conditions beyond just depression, including (but not limited to): anxiety, bipolar disorder, PTSD, ADHD, OCD, addiction, epilepsy, and Parkinson’s disease. Reputable research is constantly being published with results that suggest new or improved clinical applications of TMS. Here at South Bay TMS, we stay closely attuned to these developments. In fact, we treat patients with many of these conditions off-label on a case-by-case basis, and have consistently seen enormously positive results.

However, the FDA, as it did in 2008, is slow to react to this influx of research and evidence. In the coming years, the FDA will hopefully come to expand the approval indication of TMS to include these conditions. Again, this approval would increase patient access to these therapies, by ultimately allowing the therapy to be covered by insurance.

If you have questions about TMS and its clinical uses, please do not hesitate to contact us at South Bay TMS.


America's New Favorite Pastime, Not So Great on Safety

Have you ever Googled what the most popular sport in America is? If you haven’t, and you guessed football, then you are correct! Americans of all ages love the game of football. We all know that football is brutally physical, collisions between players happen throughout the whole game. But now that many National Football League (NFL) players have retired throughout the years, many have been diagnosed with clinical depression, Alzheimer’s disease, and a number of suicides have been committed. Doctors all over the country have linked the effect of playing football for a long period of time to serious brain diseases. There have been countless of clinical studies and even movies like Concussion (2015), starring Will Smith, that fight against the NFL, trying to prove that chronic traumatic encephalopathy (CTE) brain degeneration caused by repeated blows to the head and concussions are linked to depression, suicide, dementia, and more.

The Studies

In a study published in the journal JAMA Neurology in 2013, researchers compared depression scores of 34 retired NFL players, aged 41to 79 and with a history of at least four concussions, to 29 similar people with no history of concussions. Yes, you guessed it again, the football players were more likely to show depressive symptoms in their mood and thinking skills.

In another study in 2007, by the University of North Carolina’s Center for the Study of Retired Athletes and a general health survey of 2,552 retired NFL players, findings verified that brain trauma and clinically diagnosed depression did not link concussions to long term effects. However, later in the study, the debate continued in the journal of the American College Sports Medicine. It states that out of 595 players who have a history of three or more concussions on the field, 20.2% were diagnosed with depression.

The Science

When scientists focused on the brains of the retired players who were diagnosed with depression, they found that their brains looked much different than those players who were non-depressed. The difference was in the amount of white matter. After concussions, the brain is rattled inside which causes leakage of the white matter. Scientists saw a change in white matter in the athletes with the most cognitive impairments and the highest depression scores.

The Victims

Concussions in the NFL are a real, serious problem. Most players in the past did not know how to recognize the long term effects of the Traumatic Brain Injuries (TBI), aka concussions, and the brain disease chronic traumatic encephalopathy (CTE) because the league is not happy to talk about it. There have been countless of deaths in the NFL all related to the diseases just mentioned. CTE was found in 99% of 111 deceased brains from former NFL players in a study done in July of this year.

How TMS Has Played a Positive Role

Doctors believe that 30 to 40% of people who suffer from a concussion experience post-concussion syndrome, which leads to neurological problems, cognitive problems, and behavioral problems like depression, mood disorders, and sleep problems.

According to the Kaizen Brain Center, depression has been difficult to treat with medications after the brain has experienced a concussion. Which has led doctors to use TMS Therapy not only for retired NFL players, but also for all former athletes and military veterans.

 TMS is especially effective in these cases because after so many brain injuries, it targets and changes the brain in a very specific area.

How TMS Helped A Retired NFL Player

Tracy Scroggins of the Detroit Lions, retired in 2002 after playing in the NFL for ten years. After he retired he noticed a change in his mental health. He took action and decided to get checked out after he noticed the long term effects of the hits, impacts, and collisions that took place on the field. He was moody, easily agitated, and felt like he was not the same person he was before he experienced the injuries and head trauma from playing football. In January 2014, Scroggins stated that TMS therapy improved his mood which made a huge difference in his life, and corrected the balance of the chemicals in his brain without the use of medication.

TMS for Tinnitus

TMS for Tinnitus

-What Can TMS Not Do?​

Tinnitus is the perception of ringing or clicking in the ears, when no external noise is present. Tinnitus itself is not a disease, but instead is a common symptom of several other conditions, including ear infections, head injuries and emotional stress. As many as 15% of Americans experiences tinnitus, but only for roughly 1-2% is the symptom severe. Severe tinnitus is more common in depressed patients and can interfere with sleep, increase anxiety and impede other daily activities. At the moment, there are no medications to treat tinnitus.

TMS for Tinnitus Facts

A series of studies publish in the past 2 years suggest that TMS might offer relief to those suffering from severe or persistent tinnitus. The first meta analysis of randomized controlled studies of rTMS for tinnitus was publish in 2016. In this analysis of data from 7 separate studies, the researchers found that the mean difference between active and placebo-rTMS was clinically and statistically significant. Comparisons revealed medium to large effect sizes, where rTMS was 15 times more likely than placebo-rTMS to be associated with an improvement in the Tinnitus Handicap Inventory. The largest double blinded, placebo controlled study of TMS for tinnitus was conducted in 2015 and likewise supported the efficacy of the treatment. They found that 56% of patients who received active rTMS met the criteria for a clinical improvement, whereas only 22% of patients who received placebo treatment met the same criteria.

This new research helps to refute and overturn guidelines published in 2014 by The American Academy of Otolaryngology, which stated that clinicians should not use rTMS for the treatment of bothersome tinnitus. Their recommendation was based on insufficient data from single-site studies. The mixed results of these studies can thus be blamed on inconsistencies present in their study design, patient samples, and outcome measures. While obviously more clinical research must be conducted, TMS appears to have a promising therapeutic potential for treating bothersome tinnitus.

Theta Burst Stimulation

Theta Burst Stimulation

In the United States, the FDA-approved procedure for treating depression with TMS uses a protocol of repetitive, single-burst stimuli, called rTMS. This protocol, which has been practiced since 2008 in the US, is safe, effective and well-tolerated. However, new, potentially better TMS protocols are on the horizon. In fact, European researchers have been developing and implementing a new TMS protocol called Theta Burst Stimulation (TBS) with very promising results!

Just like conventional rTMS, theta burst therapy uses magnetic energy to stimulate the prefrontal cortex of the brain and improve depressive symptoms. The difference lies in how the stimulation is delivered. The Theta Burst protocol delivers stimuli in a unique pattern—three rapid bursts of pulses at 50 hz, repeated every 200 ms. Compared to the conventional rTMS, this protocol more continuously stimulates the brain. As a result, the treatment time is greatly reduced. Theta Burst Stimulation only takes 4 minutes, and research shows that it works equally well, if not better, than standard protocols that take upwards of 20 minutes.

Do we Use Theta Burst

At South Bay TMS we strive to remain on the cutting edge of treatment improvements documented by research to be safe and effective. Thus, we offer rTMS using the MagVenture device that is capable of providing this type of Theta Burst Stimulation. Our patients now have the option to receive both the Theta Burst and the conventional rTMS protocol in a single treatment! This doubles the effective stimulation each patient receives, and is essentially equivalent to receiving two treatments in one! We believe that this, in part, is why we have been so successful at achieving remission for our patients. Since adopting this double treatment protocol, we have had an unprecedented 93% positive response rate! Up from an 81% response rate with our former protocol that lacked TBS.

tms for autism treatment

TMS Breaking Ground in Managing Autism

TMS Breaking Ground as Autism Treatment

According to the CDC 1 in 68 American children have Autism in some form.  Autism Spectrum Disorder has seen a 3,000 percent increase in diagnoses in the last 30 years. Autism is described as difficulties with social skills, restricted repetitive behaviors, and speech and nonverbal communication. The word “spectrum” is based on the wide differences in challenges and strengths in each person with autism. The cause of the many different types of autism may be because of different genetic combinations and environmental influences. According to Dr. Jeremy Veenstra-Vanderweele, on the latest episode from the HBO series Vice, “Autism Under the Lens”, another theory on the increase in autism is based on the fact that more kids are surviving neonatal intensive care units who would not have 20-30 years ago. But more importantly, standardized tests like ADOS, that sets a numeric threshold for an autism diagnosis, is a key reason for the rise in autism cases.

The TMS Autism Treatment Method

Harvard neurologist, Dr. Alvaro Pascual-Leone pioneered the TMS technique. He explains in “Autism Under the Lens” how TMS works for Autism, “TMS is a way to inject current in the brain without having to do surgery and open up the skull. A coil of wire outside the head generates a magnetic field, and that magnetic field reaches the brain unimpeded. It makes those cells that are targeted fire in a different way. It can either make them fire more or be suppressed for some period of time. And that allows us to figure out what causal role a given brain area has for a given behavior.”

As the magnetic field is placed on the person’s scalp, this activates the part of the brain that is used to study whether that part is functioning appropriately or not.

It is also used as an intervention to down regulate the activity in that area of the brain, or up regulate it. Then, they modulate the functioning of that area that may be dysfunctional.

In people with autism, an over activity or over responsiveness is seen in certain parts of the brain. The magnetic field is used to down regulate the over excitability that might be leading to some of the behavioral difficulties and treat the underlying cause of the behaviors, rather than just treat the symptoms.

Magnetic Stimulation Plus Behavioral Intervention for Improved Effectiveness

According to the Autism Speaks blog, neuroscientist Lindsay Oberman says that TMS can be paired up with a behavioral intervention.

After receiving TMS therapy, the brain is then primed so that it can be more responsive toward a behavioral intervention.

Some studies are being done to see if the combination of TMS and behavioral intervention might improve the effectiveness of the treatment.

Back to the “Autism Under the Lens” episode, one of Dr. Pascual-Leone’s first participants, John Robison, was being interviewed. He explains his first TMS experience as “life changing”. He describes the music he was listening to on his way home as overwhelming because the radio was so clear. He felt like he was at the concert, live with the band. After his TMS therapy, Robison was able to gain a “cognitive perspective that has greatly broadened his ability to read and recognize emotions.”

John Robison is now a self-advocate for the autistic community. In addition, he runs an auto mechanic school for students with developmental disabilities. He thanks TMS for giving him the social skills needed to bring awareness to the community about neuro diversity.

The FDA clearance of TMS for the treatment of depression is a great guide that it can to be an astonishing treatment for people with autism. Clinical trials have already suggested that TMS can help relive autism symptoms like irritability and repetitive behaviors, along with improvements in eye-hand coordination and social skills.