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Frequently Asked Questions about TMS



1.      What is dTMS?


Deep Transcranial Magnetic Stimulation (dTMS) is a novel non-invasive procedure using a unique and patented coil designed to produce directed electromagnetic fields that can induce excitation or inhibition to neurons inside the brain much deeper than conventional TMS technique.


2.      How does dTMS work?


Through an electromagnetic coil placed adjacent to a patient's scalp, brief magnetic pulses are sent to a focal area of the brain. The pulses are administered by passing high current in the specially designed coil that generates a rapid changing magnetic field, which then induce a secondary electric current in the underlying brain tissue. By modifying the function of targeted deeper brains structure, dTMS generated an outstanding treatment efficacy that is not matched by any other known TMS equipment currently on the market, according to current published scientific literature. Scientific studies also showed TMS may benefit patients suffering from different kinds of neurological or psychiatric disorders.


3.      What should I expect during the procedure?


dTMS therapy is an outpatient procedure. During the procedure, the patient sits comfortably in a chair and remains fully awake and alert. A dTMS clinician positions a precisely-placed treatment coil over the left prefrontal cortex. Highly concentrated magnetic fields turn on and off repetitively in a series of short bursts. The patient will experience a light tapping sensation on the scalp. The treatment session lasts about 25-40 minutes. The clients can resume their activities immediately after the procedure concludes.

4.      I heard that it hurts. Is it painful?


No, this procedure is not painful. Some patients feel a light tapping sensation on their heads from the head piece, and a small number of patients feel scalp tenderness of mild to moderate severity, but this dissipates soon after the treatment session is completely.


5.      How long will the treatment take?


A typical dTMS treatment course consists of 5 treatments per week over 4 weeks.  Maintenance via dTMS or medication may be needed. A few small studies have shown additional maintenance treatment may be beneficial. While receiving dTMS, the patients will continue to see their primary psychiatrist for routine psychiatric care.


6.      Is dTMS safe and effective?


dTMS is a safe and non-invasive procedure with no significant side effects, no systemic effect (in contrast to drugs), and no need for hospitalization or anesthesia (in contrast to Electric Convulsive Therapy). No memory loss has been noticed, in fact, some studies have demonstrated improvement in some cognitive functions.dTMS has been scientifically proven by large multi-center double-blind sham-controlled clinical trials and certified by FDA and CE for the clinical treatment of major depression in patients who have failed to responded to one or more medication trials in their current episode of depression. The treatment has also been approved for patients who could not tolerate previous medication treatment.


7.      Does it cause any side effects?


Very few. This procedure is not systemic, meaning it does not affect your entire body. It is a magnetic field that targets only your head, no pharmaceutical drugs will be used in this procedure. You will not have side effects such as nausea, GI distress, dry mouth, fatigue or sweating as you do with medications. There is a risk for Seizures, but since 1996, there have been only 7 known documented cases of seizures with rTMS.


8.      Do I need to be sedated? Or do I need to have someone drive me home after the procedure?


You are completely awake while this procedure takes place! In fact, you can drive yourself home after the procedure, and resume your normal activities. No anesthesia will be used in this procedure.


9.      Is this type of procedure legal? I heard it isn’t FDA approved.


This procedure is legal and was approved by the FDA in January 2013 for the treatment of Depression. And other studies have proven that dTMS is very useful in the management of treatment-resistant depression. 


10.    Do third-party payers pay for this life saving procedure?


Many commercial health insurance companies have accepted TMS as a covered medical procedure for the treatment of depression. Some claims are determined on a case-by-case basis.


11.    I have Bipolar Disorder. I heard that it does NOT put me into mania after treatment, is that true?


This is True.  The chances of Treatment-Emergent Mania (TEM) is very rare. To put it into perspective, a review was done of all the studies from 1966 to 2007 on TMS, and it was found that in the TMS treatment group 0.84% of patients had TEM. And in the Sham TMS treatment group 0.73% of patients had TEM. The short answer is, very very unlikely. 


12.    Do I have to take weeks and weeks of dTMS therapy? I’ve read that some places expect me to come for about 5 weeks of daily treatment and then 3 weeks of “tapering”. 


No, the treatment length in dTMS goes by a case-by-case consideration, and the patient’s response to dTMS.