Transcranial Magnetic Stimulation, shortly known as TMS is a non-invasive method of brain stimulation that has been widely accepted and used as an effective treatment option for a wide range of brain conditions. TMS requires neither surgery nor medications. It involves an electromagnetic induction using an insulated coil placed over the scalp, focused on an area of the brain thought to play an important role in brain diseases. TMS can be used to treat patients with neurovascular diseases e.g. stroke, depression, obsessive-compulsive disorder(OCD) and Parkinson’s disease as well as pain associated with brain and nerve system.
TMS is a noninvasive procedure that uses magnetic fields to stimulate nerve cells in affected part of the brain to improve symptoms of certain brian conditions. During a TMS session, an electromagnetic coil is placed against the scalp. The coil generates magnetic pulses which pass easily and painlessly through the skull and into the brain. For instance, in patients with depression, the electromagnet delivers a magnetic pulse that stimulates nerve cells in Dorsolateral Prefrontal Cortex region which is involved in mood control and depression. TMS has been shown to be a safe and well-tolerated procedure that can be an effective treatment for patients with depression who have not gained sufficient benefits from antidepressant medications or who cannot tolerate antidepressant medications due to side-effects.
Clinical researches strongly indicate that patients who have had stroke present with paralysis on one side of the body or speech difficulties gain superior recovery benefits retrieved from TMS combined with continuous rehabilitation therapy, compared to rehabilitation alone. In addition, TMS is among noninvasive brain stimulation techniques being used to improve cognitive function in patients with memory disorders e.g. dementia and Alzheimer’s disease (AD).
Before treatment begins, a neurologist needs to identify an appropriate place to put the magnets on the head and determine the optimal dose of magnetic energy required for particular patients that might have different brain conditions. Patients will be taken to a treatment room and asked to sit in a reclining, comfortable chair. An electromagnetic coil will be placed against the head and switched off and on repeatedly to produce stimulating pulses. This results in a clicking sound that usually lasts for a few seconds, followed by a pause. Patients will feel a tapping sensation on the forehead without pain. Then a neurologist determines the amount of magnetic energy needed by increasing the magnetic dose until patient’s fingers or hands twitch, known as motor threshold. It is used as an individual reference point in determining the right magnetic dose for each patient. During the course of treatment, the amount of stimulation can be altered, depending on symptoms. After receiving treatment, patients can return to their daily lives and activities without special precautions. Each treatment session lasts approximately 30-60 minutes. Since this treatment often involves delivering repetitive magnetic pulses to produce longer lasting changes in brain activity, thus it is also called repetitive TMS. The numbers of treatment session required for each patient are primarily depending on particular brain conditions.
Neuroscience Center, Bangkok International Hospital offers TMS with advanced model, allowing magnetic dose for brain stimulation to be widely adjusted, from low frequency stimulation to theta burst stimulation. Theta burst stimulation is a newer form of TMS in which high frequency magnetic pulses are applied in a certain pattern, called bursts. Our TMS has been designed to treat several conditions related to neurological system. For ease and convenience, both outpatient and inpatient services are available. Moreover, TMS can be provided at bedside in case that patients have movement difficulties e.g. leg weakness or paralysis. In spite of the fact that TMS is a minimally invasive and effective treatment, it should be conducted by highly specialized neurologists in certified hospitals with international standard of care. Close treatment monitoring and follow-up remain important in order to achieve the best possible outcomes as well as to improve patient’s quality of life in the long run.