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By Mayo Clinic staff
Transcranial magnetic stimulation is usually done on an outpatient basis in a doctor's office or clinic. It requires a series of treatment sessions to be effective. Generally, sessions are carried out daily, five times a week for four to six weeks.
Your first treatment
Before treatment begins, your doctor will need to identify the best place to put the magnets on your head and the best dose of magnetic energy for you.
Most likely, during your first appointment:
- You'll be taken to a treatment room. You'll be asked to sit in a reclining chair, and you'll be given earplugs to wear during the procedure.
- An electromagnetic coil will be placed against your head. The electromagnetic coil is switched off and on repeatedly to produce stimulating pulses. This results in a tapping or clicking sound that usually lasts for a few seconds, followed by a pause. You'll also feel a tapping sensation on your forehead. This part of the process is called mapping.
- The amount of magnetic energy needed will be determined. Your doctor will increase the magnetic dose until your fingers or hands twitch. Known as your motor threshold, this is used as a reference point in determining the right dose for you. During the course of treatment, the amount of stimulation can be changed depending on your symptoms and side effects.
Once the coil placement and dose are identified, you're ready to begin.
During transcranial magnetic stimulation
Here's what to expect during each treatment:
- You'll sit in a comfortable chair. The magnetic coil is placed against your head.
- The machine will be turned on. You'll hear clicking sounds and feel tapping on your forehead.
- The procedure will last about 40 minutes. You'll remain awake and alert. You may feel some scalp discomfort during the treatment and for a short time afterward. The entire appointment typically lasts about one to two hours.
After treatment, you can return to your normal daily activities.
There are different ways to perform the procedure. Techniques may change as experts learn more about the most effective ways to perform treatments.
- Brain stimulation therapies. National Institute of Mental Health. http://www.nimh.nih.gov/health/topics/brain-stimulation-therapies/brain-stimulation-therapies.shtml. Accessed Oct. 18, 2012.
- Hales RE, et al. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. Washington, D.C.: American Psychiatric Publishing; 2008. http://www.psychiatryonline.com/resourceToc.aspx?resourceID=5. Accessed Oct. 22, 2012.
- Holtzheimer PE. Unipolar depression in adults: Treatment with transcranial magnetic stimulation (TMS). http://www.uptodate.com/index. Accessed Oct. 22, 2012.
- Rasmussen KG. Some considerations in choosing electroconvulsive therapy versus transcranial magnetic stimulation for depression. Journal of ECT. 2011;27:51.
- Cusin C, et al. Somatic therapies for treatment-resistant depression: ECT, TMS, VNS, DBS. Biology of Mood & Anxiety Disorders. 2012;2:14.
- Transcranial magnetic stimulation (TMS or rTMS). National Alliance on Mental Illness. http://www.nami.org/Content/ContentGroups/Helpline1/Transcranial_Magnetic_Stimulation_(rTMS).htm. Accessed Oct. 24, 2012.
- Kung S (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 1, 2012.
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