Transcranial Magnetic Stimulation Therapy: When is it used?

Transcranial Magnetic Stimulation Therapy is a novel alternative for the treatment of depression. Specifically, it has become an option over Electroconvulsive Therapy, also called "shock therapy" which, for years, has been used for cases resistant to other treatments.

Depression is a disease that has increased throughout the world and constitutes one of the main causes of disability. Some people do not respond well to conventional treatments and this is where transcranial magnetic stimulation therapy can be a valid alternative.

What is transcranial magnetic stimulation therapy?

Transcranial magnetic stimulation therapy is an alternative technique used in the treatment of depression.

Transcranial Magnetic Stimulation Therapy (TEM) is a non-invasive procedure that uses magnetic fields to stimulate brain cells. Magnetic energy pulses are directed to those areas that are related to mood control.

This type of therapy is painless and its application seeks to better communicate the different parts of the brain. In reality, it is not known how this process works, but it is clear that it has positive effects in alleviating the symptoms of depression and improving mood.

When magnetic pulses are applied at regular intervals in transcranial magnetic stimulation therapy, it is called repetitive TEM. These pulses are the same as those used in an MRI, for which they are considered safe.

When and what is it used for?

Transcranial Magnetic Stimulation Therapy it is used to treat major depression. This disorder, in principle, is treated with drugs and psychotherapy, which have a positive effect in most cases.

When that first-line treatment is not effective, TEM may be a good alternative. In several countries of the world this therapy is also used in the treatment of other conditions such as the following:

  • Anxiety disorders.
  • Schizophrenia.
  • Post-traumatic stress disorder.
  • Parkinson's disease.
  • Stroke rehabilitation.
  • Alzheimer disease.
  • Nicotine addiction.
  • Chronic pain.

Similarly, transcranial magnetic stimulation therapy offers promising results in the treatment of fibromyalgia, tinnitus, Tourette syndrome, multiple sclerosis, and autism spectrum disorder.

Read also: How to detect depression

What side effects does transcranial magnetic stimulation therapy have?

Transcranial magnetic stimulation therapy does not require the use of anesthesia and, in general terms, is exceptionally well tolerated by almost all patients. It does not require surgery or electrode implantation, as occurs in vagus nerve stimulation or deep brain stimulation.

Unlike Electroconvulsive Therapy, it does not require sedation, does not cause seizures, and has no side effects on memory and cognition. However, it can cause other side effects such as the following:

  • Headache (this is the most common effect).
  • Scalp discomfort.
  • Tingling, contractions, or spasms in the facial muscles.
  • Daze.

The doctor can control these side effects by reducing the level of stimulation or ordering the intake of a pain reliever prior to the procedure. In rare cases, more severe side effects may occur, such as the following:

  • Seizures.
  • Mania. It is more common in people with bipolar disorder.
  • When there is no adequate protection there may be hearing loss.

Which People Are Unsuitable For Transcranial Magnetic Stimulation Therapy?

People with metal prostheses or pacemakers are not candidates for the use of this therapy.

People who have epilepsy or a family history of seizures are not candidates to transcranial magnetic stimulation therapy. The procedure is also not suitable for those who have metallic objects such as the following:

  • Aneurysm clips.
  • Deep brain stimulators.
  • Stents.
  • Metal implants in the eye or ear.
  • Pacemaker.
  • Bullet or shrapnel remains.

Dental fillings or braces do not interfere with treatment. On the other hand, this type of therapy is not suitable for people with the following conditions:

  • History of substance abuse or psychosis.
  • Brain damage from injury or illness.

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What to expect from the procedure

Transcranial magnetic stimulation therapy is done in a doctor's office or hospital. In general terms, five weekly sessions are required, one per day, for a period of between four and six weeks to be effective.

In the first session, the doctor identifies the best dose of magnetic energy suitable for the case. Also the areas of the head where the magnets should be placed. Typically this is done in 60 minutes and requires the following actions:

  • The patient should sit in a reclining chair and put ear plugs.
  • An electromagnetic coil is placed on the head. It turns off and on, producing a tapping sound with pauses. This process is called "mapping."
  • Magnetic energy is applied until the fingers or hands contract. This point is called the "motor threshold" and determines the amount of magnetism that each person must receive.

After that first session, the others will be about 40 minutes. During them, the patient must sit in the reclining chair; then, the electromagnetic energy will be applied. The person feels a noise and small bumps on the forehead. Afterward, you can return to your normal activities.

An option against depression

The data indicate that between 50 and 60% of people who attend transcranial magnetic stimulation therapy benefit this. In some cases the symptoms of depression are reduced and in others they disappear completely.

More studies are still required to know how effective it is in other conditions. In addition, there is not enough data on the long-term side effects this therapy can have. For now, everything indicates that it is a promising option.

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