What is repetitive transcranial magnetic stimulation(rTMS)?

 

Repetitive Transcranial Magnetic Stimulation

As a treatment for several psychiatric and neurological disorders, Advanced Mental Health Care offers repetitive Transcranial Magnetic Stimulation (rTMS) treatment.

Approved by the FDA since 2008,  the rTMS procedure is a brain stimulation therapy that uses magnetic pulses to activate parts of the brain, resulting in symptom improvement. Repetitive TMS is when a series of pulses are used to create longer lasting effects. It can last anywhere from 30 minutes to years. The pattern of the pulses, the intensity (amount of power), the total number of the pulses, position of the coil, type of coil and more details are all factors that contribute to the lasting effects of rTMS.

What is conventional or standard rTMS?

Conventional rTMS uses magnetic coils that are flat, helical, double helix (figure eight) shaped or clam shaped. They reach less than 2cm below the surface of the skull. Several companies make these coils, but the first FDA approved coil for depression was made by Neuronetics. Most of the research with rTMS was done with coils made by Magstim.

Standard rTMS is presently FDA approved for the treatment of depression in patients that have failed one antidepressant in the current episode. It is much more efficacious when it is used as an augmentation agent to medication.

 

Neurostar rTMS Therapy

The rTMS procedure is delivered by the NeuroStar machine system and created by Neuronetics, Inc. The company “focuses on developing and commercializing noninvasive therapies to treat chronic psychiatric and neurologic disorders.” A study sponsored by the National Institute for Mental Health, published in 2010, provides evidence of its success in helping patients achieve improvement and remission. The device has received FDA approval for use in patients with treatment resistant depression and has been used off-label to successfully treat several other disorders.

Why It Works

Using a highly focused, pulsed magnetic field, the NeuroStar rTMS machine stimulates function in the cortical neurons, which are the nerve cells that make up the area of the brain that affects mood. Patients are also drawn to the treatment because of the lack of side-effects associated with most anti-depressant medications.

rTMS is:

  • Non Invasive:  Does not involve surgery
  • Non Systemic:  Does not circulate in the blood stream
  • Safe
  • Effective
  • Has few side effects
  • Is delivered in an outpatient setting
  • Patients can return to their normal activity immediately after treatment
  • Treatment can be delivered seven days a week
  • Treatment is generally well tolerated by patients with very few side effects reported.

 

Treatment at AMHC

Your rTMS treatment and care can be supervised by Dr. Aron Tendler, a Principal Investigator who was involved in the studies that led to the FDA approval of the Brainsway dTMS device. Drs. Laura and Mark DeLuca are also very experienced in rTMS and dTMS. Most impressively, AMHC is one of the few facilities in the nation that has three FDA-approved devices (Brainsway, Neurostar, Magstim).

 

Determining Treatment Appropriateness

Potential candidates for rTMS are screened by the psychiatrist through a comprehensive evaluation.  The psychiatrist will assemble a complete medical and medication history and assess the risk/benefit of completing rTMS therapy.  The doctor also will thoroughly explain the procedure, including the frequency and duration of treatment and any possible side effects.

Additionally, If you already undergoing treatment at another location in the country and are just in town for a few days, your treating physician can send us your treatment parameters and orders and we will continue treatments.

 

Treatment Sessions

The technicians at Advanced Mental Health Care are highly trained in the use of the machine and in patient care during therapy.  A patient is awake and alert during each therapy session, as no anesthesia or sedation is required.  Seated comfortably, a patient can communicate with the technician who continually supervises the therapy. A typical course of treatment is twenty to thirty treatments, spanning four to six weeks. A patient is assessed for side effects and changes in symptoms at each treatment session and follow-up with Dr. Tendler on a weekly basis.

 

Cost

“People ask me if it’s worth the price for rTMS and I say absolutely.  For the price of admission, I’ve got my life back.”

A NeuroStar patient discussing the cost of therapy

 

At AMHC, we offer the lowest price in the county.(Visit our FEES page) and is considered out-of-network care for insurance billing purposes.  Patients may be able to receive reimbursement for the cost of their treatment based on their own individual insurance coverage. We encourage you to call the office and speak with our TMS Program Administrator about your insurance options or to learn more about TMS and how it can benefit you.

Almost all insurance companies cover rTMS and dTMS for Major Depression if the patient has failed or was intolerant to four medications in the current episode. Additionally, rTMS and dTMS is covered if it was effective for a past episode.