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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 can begin, your doctor will need to identify the best place to put the magnets on your head and will need to find the best dose of magnetic energy for you.
This is what will most likely occur 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 is placed against your head. The electromagnetic coil is switched off and on repeatedly, up to 10 times a second 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 light tapping sensation on your forehead. This part of the process is called mapping.
- The amount of magnetic energy needed is 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. The treatment itself will last about 40 minutes. The entire appointment typically lasts about one to two hours.
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 is turned on. You'll hear clicking sounds and feel tapping on your forehead.
- Each treatment session lasts about 40 minutes. You'll remain awake and alert. You may feel some scalp discomfort during the treatment and for a short time afterward.
- After treatment, you can return to your normal daily activities.
There are different ways to perform the procedure. Techniques may change as more is learned about the most effective ways to perform treatments.
- Padberg F, et al. Repetitive transcranial magnetic stimulation of the prefrontal cortex in depression. Experimental Neurology. 2009;219:2.
- Kim D, et al. Transcranial magnetic stimulation in the treatment of psychiatric disorders. Current Psychiatry Reports. 2009;11:447.
- Loo CK, et al. A review of the safety of repetitive transcranial magnetic stimulation as a clinical treatment for depression. International Journal of Neuropsychopharmacology. 2008;11:131.
- George MS, et al. Nonpharmacological somatic treatments. In: Hales RE, et al. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. Arlington, Va.: American Psychiatric Publishing; 2008. http://www.psychiatryonline.com/content.aspx?aid=338825. Accessed June 21, 2010.
- Barbara Woodward Lips Patient Education Center. Transcranial magnetic stimulation (TMS). Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2009.
- Rossini, Paolo M, et al. Transcranial magnetic stimulation: Diagnostic, therapeutic, and research potential. Neurology. 2007;68:484.
- Fitzgerald, Paul B, et al. The use of repetitive transcranial magnetic stimulation and vagal nerve stimulation in the treatment of depression. Current Opinion in Psychiatry. 2008;21:25.
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