Deep TMS in Psychiatry
Pharmacotherapy (use of drugs) and Psychotherapy (use of counselling or related therapies) are the major treatment strategies in psychiatry. While pharmacotherapy aims at bringing chemical balance in the neural circuits, psychotherapy aims to bring mental equilibrium. Complementing the two, Non-Invasive Brain Stimulation (NIBS) works as an adjuvant to the existing therapies.
Deep Transcranial Magnetic Stimulation (DTMS) is one of the NIBS treatments approved by the United States Food and Drug Administration (US-FDA) for its use in the treatment of Obsessive-Compulsive Disorder (OCD), Anxiety Depression, and Smoking Cessation. know more about DTMS in ANC
What is the technology behind DTMS?
An electromagnetic field in the intensity range of 1-1.5T is generated from an electromagnet fitted inside an insulated helmet. This field is directed into the human brain in a specific direction and magnitude, reaching up to a depth of about 4 cm inside the brain. know more
What happens when the magnetic field gets into the human brain?know more
It induces an electric field (E-field) of variable intensities from 80-140V/m in the target areas of the brain according to Faraday’s law of electromagnetic induction. Under the effect of the E-field, the brain cells called neurons and glia undergo a functional as well as microscopic structural changes called as ‘neuronal plasticity’.
Which brain areas are targeted in DTMS and how?know more
The electromagnets placed inside the insulated helmets are of various patented designs, which influence specific brain areas. There are 3 helmets approved by US-FDA so far, the H1, H4, and H7. The following table explains the target brain area(s) influenced by the E-field and the psychiatric conditions treated using these helmets.- consider using brain image for the helmets and areas.
|
H1 helmet |
Left dorsolateral prefrontal cortex (left dlPFC) |
Depression, Anxiety |
|
H4 helmet |
Bilateral Insula and prefrontal cortex |
Smoking cessation |
|
H7 helmet |
Bilateral dorsomedial prefrontal cortex (dmPFC) and anterior cingulate cortex (ACC) |
OCD |
Neuromodulation in Psychiatry
Non-Invasive Brain Stimulation (NIBS) is a Neuromodulation technique widely used in the clinical practice of psychiatry. Among all the NIBS techniques, Transcranial Magnetic stimulation (TMS) is the most commonly technique used in psychiatry.
Deep TMS:
Deep TMS or DTMS is a revolutionary TMS technology, approved by the US-FDA, that utilizes the magnetic fields to stimulate deeper and broader regions of the brain ensuring extensive activation of the brain cells.
What happens in a DTMS session?
- Screening the patient for electromagnetic field compatibility
- Choosing the appropriate treatment protocol
- Initial psychological assessment
- Average session duration is 20 minutes
- Resting Motor Threshold will be estimated prior to first session
Benefits & Advantages of DTMS:
- Safe and highly effective
- Convenient and comfortable to the patient
- Treatment for resistant conditions
- Minimal to nil side effects