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What Does “Deep” Stand for in Deep TMS?


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Deep TMS, also called dTMS, is a type of TMS (transcranial magnetic stimulation) technology. It uses magnetic pulses to help regulate neuron activity, and therefore relieve symptoms, in people who have been diagnosed with certain mental health conditions, like depression and OCD (obsessive-compulsive disorder). Deep TMS helps relieve symptoms when patients haven’t seen an improvement with other treatment options and is performed in the same manner as traditional standard TMS.

How is Deep TMS Performed?

Like rTMS (which is the “standard” type of TMS performed), dTMS is an outpatient procedure and doesn’t require anesthesia.

Before starting a dTMS session, a technician carefully fits a helmet over your head. Inside of this helmet is a magnetic coil that safely emits magnetic pulses throughout the session (one session typically lasts approximately 20 minutes). Patients can drive themselves home or to work immediately following a TMS treatment session. 

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Why Does Deep TMS Have the Word “Deep” in the Name?

Many of my patients are curious why dTMS is called “deep,” if it’s performed the same way as standard TMS. Deep TMS gets its name from its ability to safely activate neurons in deeper parts of the brain, compared to standard TMS that activates neurons that are closer to the surface of the brain. 

Deep TMS uses a unique H-shaped magnetic coil that allows magnetic pulses to reach deeper areas of the brain (3.2 cm) associated with mood regulation.(1) Standard TMS uses a figure-eight coil shape that can reach approximately 1-2cm in depth.(2)

How Effective is Deep TMS?

Deep TMS is clinically proven and FDA-approved to relieve symptoms of depression, OCD, and tobacco cigarette cravings and urges.

Clinical studies show that dTMS is safe and effective in patients who have been diagnosed with treatment-resistant depression (meaning that they don’t respond to antidepressants and talk therapy). One study, in particular, showed that patients with treatment-resistant depression who receive dTMS treatment are twice as likely to achieve remission compared to patients who received placebo treatment.(3)

A recent analysis of real-world clinical data tells us that dTMS is successful in treating symptoms of OCD in patients who do not respond to medication and behavioral therapy. This analysis also found that patients continued to see a reduction in the severity of their symptoms with additional treatment sessions.(4)

Studies also show that dTMS is safe and effective in helping people achieve short-term smoking cessation. Deep TMS can help reduce cravings and improve the quit rate among long-time smokers.(5)

While dTMS is only FDA-approved to treat depression, OCD, and smoking cessation, research shows that it may be safe and effective for other conditions. 

Who Can Benefit From Deep TMS?

Deep TMS is recommended for patients diagnosed with certain conditions who do not find relief from their symptoms with medication and talk therapy. 

Deep TMS is FDA-approved for the treatment of:

  • Depression
  • OCD
  • Smoking cessation

Research shows that deep TMS may also be a safe and effective treatment for people with:

  • Fear and anxiety disorders(6)
  • Addiction(7)
  • Migraines(8)

Most patients who are candidates for standard TMS (rTMS) are also good candidates for dTMS. 

Can you benefit from TMS?

 If you’d like to learn more about deep TMS and whether it can help you, contact us online or call 212.731.2033 to make an appointment. 


Resources:

1. BrainsWay TMS. How does Deep TMS compare to standard rTMS? https://www.brainsway.com/professionals-faqs/how-does-deep-tms-compare-to-standard-rtms/. Accessed September 10, 2021.

2. McClintock SM, Reti IM, Carpenter LL, et al. Consensus Recommendations for the Clinical Application of Repetitive Transcranial Magnetic Stimulation (rTMS) in the Treatment of Depression. Journal of Clinical Psychiatry. Jan-Feb 2018;79(1):16cs10905. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846193/. Accessed September 13, 2021.

3. Levkovitz Y, Isserles M, Padberg F, et al. Efficacy and safety of deep transcranial magnetic stimulation for major depression: a prospective multicenter randomized controlled trial. World Psychiatry. February 2015;14(1):64–73. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4329899/. Accessed September 13, 2021.

4. Roth Y, Tendler A, Arikan MK, et al. Real-world efficacy of deep TMS for obsessive-compulsive disorder: Post-marketing data collected from twenty-two clinical sites. J Psychiatr Res. 2021;137:667-672. https://pubmed.ncbi.nlm.nih.gov/33183769/. Accessed September 10, 2021.

5. Zangen A, Moshe H, Martinez D, et al. Repetitive transcranial magnetic stimulation for smoking cessation: a pivotal multicenter double-blind randomized controlled trial. World Psychiatry. 2021;20(3):397-404. https://pubmed.ncbi.nlm.nih.gov/34505368/. Accessed September 13, 2021. 

6. Cirillo P, Gold AK, Nardi AE, et al. Transcranial magnetic stimulation in anxiety and trauma‐related disorders: A systematic review and meta‐analysis. Brain Behav. 2019;9(6):e01284. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6576151/. Accessed September 13, 2021. 

7. Bolloni C, Badas P, Corona G, and Diana M. Transcranial magnetic stimulation for the treatment of cocaine addiction: evidence to date. Subst Abuse Rehabil. 2018;9:11–21. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5967377/. Accessed September 13, 2021.

8. Rapinesi C, Del Casale A, Scatena P, et al. Add-on deep Transcranial Magnetic Stimulation (dTMS) for the treatment of chronic migraine: A preliminary study. Neurosci Lett. 2016;623:7-12. https://pubmed.ncbi.nlm.nih.gov/27132086/. Accessed September 13, 2021.

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.


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