By Dr. David Woo - April 21, 2022

Transcranial magnetic stimulation (or “TMS”) is an incredible breakthrough in the treatment of depression, and it’s an excellent option for patients who haven’t experienced adequate symptom relief with antidepressants and therapy. But many patients wonder how the effect that TMS has on their brain actually works to alleviate the symptoms of depression.

Here are three ways that TMS affects the brain in order to relieve depression symptoms:

1. TMS Therapy Stimulates the Brain’s Electrical Activity

Antidepressant medications work to relieve the symptoms of depression by stimulating the brain chemically. Research suggests that depression is often caused by what doctors frequently refer to as a “chemical imbalance” – this means that the levels of certain neurotransmitters (“chemical messengers” produced by your nervous system that transmit messages between brain cells) may be either too high or too low. Antidepressant medications help adjust these neurotransmitter levels, and it may take some trial-and-error to determine which antidepressant will work best for you.

Some patients try multiple antidepressants, but still don’t see any, or enough, relief from their symptoms. For patients like this, TMS may succeed where antidepressants failed. This is because TMS stimulates the brain electrically rather than chemically (note that TMS is not the same as ECT, and “electrical” stimulation does not mean that your brain is being electrocuted!). TMS uses safe, magnetic pulses to stimulate specific regions of the brain, which increases electrical activity in the brain.

2. TMS Targets Specific Regions of the Brain That are Associated with Depression

TMS targets an area of the brain called the prefrontal cortex, which is the area of the brain that research suggests is associated with mood disorders, such as depression.(1,2) Your first TMS session will be what we call a “brain mapping” session: the TMS machine will send magnetic pulses into the brain and register its response until we find the optimal location for brain stimulation. This helps ensure that magnetic pulses are being localized to the place where they’re most likely to have an impact on your moods.

3. TMS “Resets” the Brain’s Neural Pathways

Exciting new clinical studies show that TMS not only stimulates the brain but may also affect how neurons (brain cells) connect to each other. More specifically, it makes the network of neurons within your brain vulnerable to reorganization, which means that it “resets” the pathways between neurons and causes them to need to reorganize how they communicate with each other.  

The research also shows that after a TMS session, these neurons will show a preference for the new neural pathway, meaning that they may cease to use the old neural pathway that may be associated with the patient’s depression symptoms.(3,4) So it’s thought that, much like turning your computer on and off when it’s not working, “resetting” these neural pathways helps the brain to recover from depression.

Want To Learn More About TMS in NYC?

If you’d like to learn more about TMS in Midtown Manhattan, contact us online or call our office at (212) 731-2033.

Resources:

1. Buchheim A, Viviani R, Kessler H, Kächele H, Cierpka M, Roth G, George C, Kernberg OF, Bruns G, Taubner S. Changes in prefrontal-limbic function in major depression after 15 months of long-term psychotherapy. PLoS One. 2012; 7(3):e33745. https://pubmed.ncbi.nlm.nih.gov/22470470/. Accessed March 38, 2022.
2. Pizzagalli, D.A., Roberts, A.C. Prefrontal cortex and depression. Neuropsychopharmacol. 2022; 47:225–246. https://pubmed.ncbi.nlm.nih.gov/34341498/. Accessed March 31, 2022.
3. Kozyrev V, Staadt R, Eysel UT, and Jancke D. TMS-induced neuronal plasticity enables targeted remodeling of visual cortical maps. PNAS. June 2018;115(25):6476-6481. https://www.pnas.org/doi/10.1073/pnas.1802798115. Accessed March 17, 2019.
4. Ruhr-University Bochum. What effect does transcranial magnetic stimulation have on the brain? Science Daily. Published June 5, 2018. https://www.sciencedaily.com/releases/2018/06/180605103511.htm. Accessed March 17, 2019.  

Dr. David Woo

Dr. Woo has been seeing patients in private practice since 2002, always with the goals of combining evidence-based medicine with psychodynamic psychotherapy and collaborating with other mental health professionals to ensure the best possible outcomes for his patients. He has been certified to administer TMS at his practice since 2017. His greatest clinical interests include helping patients suffering from depression, anxiety, and obsessive compulsive disorder.