Transcranial Magnetic Stimulation (TMS)

Transcranial Magnetic Stimulation (TMS) is a non-invasive, physical approach to psychiatric treatment. TMS is based on the principle of electromagnetic induction that allows us to stimulate or inhibit the neuronal activity of specific brain areas. An electrical impulse generates a magnetic field that penetrates through the skull and induces the stimulus in the nervous tissue that modulates the activity of neurons.

How does Transcranial Magnetic Stimulation (TMS) work?

The effect of TMS can be of two types:

• Activation: Induction/increase of the electrical activity of an otherwise inactive or hypoactive area.
• Inhibition: Reduction of electrical activity in a hyperactive area.

Repetitive Transcranial Magnetic Stimulation (rTMS)

Multiple TMS pulses given consecutively are referred to as repetitive or rTMS. Longer repetitive pulse sequences may induce long-term neuroplastic changes, offering enduring alterations that carry therapeutic potential. For this purpose, TMS pulses are usually delivered in trains or in more complex patterns, like Theta Burst Stimulation.

Theta Burst Stimulation (TBS)

Theta Burst Stimulation (TBS) is a type of stimulation characterized by the rapid repetition of high frequency stimuli (50Hz) divided into triplets of stimuli. Two types of TBS protocols are distinguished:

• Continuous TBS: Reduces cortical activity.
• Intermittent TBS: Increases cortical activity.

How Does it Work?

In TMS treatment, an instrument called a stimulator supplies electrical energy to a magnetic coil that generates a magnetic field in the brain for a short period of time. The magnetic field produced by the coil passes unhindered through the scalp to the brain without any dispersion and almost painlessly, thus being able to reach the underlying brain structures, in particular the cerebral cortex, and modify its electrical activity in order to improve symptoms of psychiatric disorders.

The coil is placed on the head in such a way as to allow the magnetic field to reach the brain region of interest. The magnetic stimulus produces a recordable response, which is manifested by a noise similar to a series of clicks and a tingling sensation on the skin of the head. The most commonly reported side effect of TMS is a mild and transient muscle-tension headache.

Treatment Available at the Following Clinics

• Cheshire Clinic
• Liverpool Clinic

Consultation Process

When you come to our clinic for a medication review, our friendly consultant will need to undertake a full psychiatric assessment. This can take up to 2 hours. They will take a full history and, depending on the outcome and information gathered, they will have the ability, where they see fit and with patient agreement, to suggest possible medication changes.