Transcranial Magnetic Stimulation: A Promising Method for Treating Depression

 

Transcranial Magnetic Stimulation

Transcranial magnetic stimulation or TMS is a noninvasive form of brain stimulation technique. It uses magnetic fields to activate specific regions of the brain. TMS works by inducing small electric currents in the brain using rapidly changing magnetic fields. The stimulation is delivered through a wire coil placed near the head over the scalp area of interest. TMS offers a unique and innovative way to study and treat various psychiatric and neurological conditions in a completely noninvasive manner.

 

History and Development

 

The idea of using rapidly changing magnetic fields to stimulate brain activity traces back to the mid-1980s. It was first demonstrated in 1985 by Anthony Barker and his colleagues at Sheffield University in England. Initial experiments showed that TMS could be used to temporarily disrupt brain activity when applied over the motor cortex. This helped establish TMS as an effective technique for neuromodulation. Over the following decades, TMS systems continued to improve with better stimulation coils and control over parameters like frequency and intensity. The FDA approved TMS therapy in 2008, making it a viable treatment option for certain conditions. Since then, TMS has emerged as a promising research and clinical tool due to its ability to modulate brain networks noninvasively.

 

How Does TMS Work?

 

When the TMS coil is placed near the scalp, it generates rapidly changing magnetic fields. These magnetic pulses pass unimpeded through hair, scalp and skull to directly stimulate cortical neurons in the brain. The electric currents induced are thought to temporarily excite or inhibit local neural circuits depending on stimulation parameters like frequency. Low frequency TMS below 1 Hz inhibits cortical activity while high frequency protocols above 5 Hz excite it. The Transcranial magnetic stimulation areas can also be targeted specifically by placing the coil over the region of interest as identified using MRI/MEG. Modern TMS devices can deliver single pulses or repeated trains of stimuli controlling conditions like pulse intensity, duration and interpulse intervals. This makes TMS a versatile tool for both research and therapy applications.

 

Safety and Side Effects

 

Overall, TMS is considered quite safe based on extensive research. Most side effects are localized and mild like scalp pains, headaches and faint sensations during stimulation. Seizures are exceedingly rare, estimated to occur in less than 1 in 1000 patients. Precautions are taken for those with metal implants and epilepsy history. Long term risks are still being evaluated but considered minimal. Stimulation below equipment output limits should pose no risk of tissue damage. At therapeutic frequencies in clinical use, side effects are typically transient lasting few minutes after the session ends. With careful screening and monitoring during treatment, TMS can generally be delivered safely. This favorable safety profile is a major advantage over other invasive techniques.


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