Initial consultation
The first step in our TMS treatment process is meeting with a prospective patient to determine whether or not TMS therapy is an appropriate treatment for him or her. During this initial consultation, one of our TMS psychiatrists will meet with a prospective patient and review the patient’s symptoms, history of treatments and responses, and discuss a potential treatment plan.
First TMS therapy session
If TMS therapy has been prescribed for a patient, an initial treatment session will be scheduled for a 1.5 to 2 hour block of time. TMS treatment takes place in an outpatient setting and does not require any form of sedation during the procedure. The patient is seated in a chair similar to one found in a dentist’s office or beauty salon.
During the initial treatment session, one or more of our TMS psychiatrists will perform a motor threshold determination and localization procedure in which the appropriate energy settings and placement of the treatment coil are determined. During this part of the procedure, a magnetic pulse will be given to find the level of magnetic energy that is enough to cause movement in a patient’s fingers. Later, the magnetic coil is moved forward and positioned to be ready to direct magnetic pulses towards the left frontal lobe, specifically the Dorsal Lateral Prefrontal Cortex (DLPFC), a brain area implicated in depression.
After the magnetic coil has been correctly positioned and appropriate settings determined, TMS treatment is begun. The magnetic coil device delivers magnetic pulses that cause electrical changes within underlying brain circuitry.
During the TMS treatment session, a patient will sit reclined, awake and alert, in a chair while the TMS treatment device delivers a rapid sequence of magnetic pulses over several seconds. These sequences of magnetic pulses are repeated a few times per minute, with resting time in between active pulse sequences. The active magnetic pulses can create the feeling on a tapping sensation on the scalp. Because the TMS treatment device emits a loud clicking sound while the magnetic pulses are discharged, ear plugs are offered to our patients. Some patients will elect to listen to music using noise-canceling or noise-blocking headphones.
Overall, the procedure is well-tolerated. During the treatment sessions, patients can listen to music, watch television, or simply relax.
Subsequent treatment sessions
Each patient’s individual treatment parameters (e.g., the motor threshold) will impact the duration of each subsequent treatment session. For most individuals, these sessions typically take 25-45 minutes to perform. A typical course of TMS therapy involves treatment five days a week for four to six weeks, but this can vary based on a patient’s response to treatment. A set of tapering TMS treatments is sometimes used to ensure ongoing results. As our patients are progressing through their TMS therapy treatments, our TMS staff will regularly assess progress and adjust our treatment plan as needed.
After a TMS therapy session
Our patients typically resume their normal activities and go about their day immediately after each session, without any special restrictions or limitations.