Repetitive Transcranial Magnetic Stimulation (rTMS) is a simple and non-invasive procedure that uses electromagnetic induction to stimulate specific areas of the brain. rTMS is also used to stimulate neural tissue such as motor cortex (that controls motor function), corticospinal tract (the neural pathways that terminate in the spinal cord) or frontal cortex (that contributes to personality and control emotions).
rTMS can be used either diagnostically or therapeutically. Diagnostically, rTMS is used to evaluate the extent of damage caused by neurological disorders such as stroke and multiple sclerosis, and injuries. For therapeutic purposes, high-frequency repetitive TMS is used as a treatment for major psychological issues such as depression and anxiety.
How does rTMS work?
An electromagnetic generator, in the form of an insulated copper coil, is placed near (no contact) the scalp to a specific area of the brain. This generator produces small magnetic pulses that penetrate the skull into the brain and spinal nerve tract. The magnetic pulses generated can be aimed to reach specific targets in the in the brain. Since the pulses are similar to those used in magnetic resonance imaging (MRI), rTMS is quite safe.
What does rTMS Treatment involve?
A regular rTMS treatment session lasts between 15 to 45 minutes. The patient is usually awake and remains aware during the entire procedure. During the treatment, the patient sits comfortably in an upright position while the coil is positioned over his or her head. The number of treatment sessions is determined by the patient’s needs.
The patient is also required to wear earplugs to drown out the noise made by the machine and to protect his or her hearing.
Patients are required to remove all metallic or “magnetic sensitive” objects before going in for the treatment. Patients with metallic devices or implants in or near their heads are exempted from the procedure. The rule of thumb for the position of “magnetic sensitive” objects is within 12 inches of the magnetic coil.
The Benefits of rTMS
The use of rTMS, as a treatment for neurological conditions, has been proving effective. Dr Rogers of the Northwestern University cited that rTMS activated “neuronal cells at the molecular level” lowers the inhibition of some neurons which are easily spread through other neural pathways.
Studies have shown rTMS as a valuable complementary to treatment protocols for degenerative conditions (such as spinal cord injury, stroke, and traumatic brain injury), and neurological conditions (such as chronic neural pain, Parkinson’s disease, depression and multiple sclerosis).
Side Effects of rTMS
rTMS is a safe treatment method, however, like every other treatment protocol; there are a small number of people who are affected by the treatment. Some of the side effects include headaches, scalp pain, facial twitching, and transient hearing problems. The pain and discomfort related to the treatment can be relieved using pain relieving medication, adjustments to the position of the coil and stimulation settings. Patients should also wear earplugs to prevent long-term hearing problems. The most serious side effect is seizures, which are reported on rare occasions.
Repetitive Transcranial Magnetic Stimulation is a welcome addition to the treatment and rehabilitation protocols for most neurological conditions and degenerative diseases.
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