- May 10, 2022
- By admin
Transcranial magnetic stimulation can help fix your nerves
How transcranial magnetic stimulation works?
TMS (transcranial magnetic stimulation) is a non-invasive treatment that generates a magnetic field using an electromagnetic coil. TMS stimulates the brain cortex by emitting short magnetic pulses that pass through the skull and into the brain painlessly. Both at the stimulation site and at a distance, these pulses elicit changes in cortical excitability. Pain is a set of unpleasant sensory and emotional sensations linked to actual or potential tissue damage. Pain is generally associated with a sickness or injury, but it can also be linked to one’s emotional state. Pain is linked to several brain locations, including the hypothalamus, amygdala, thalamus, somatosensory cortex, insula, anterior cingulate cortex, and prefrontal cortex. Around 30 years ago, a group of researchers constructed a high-voltage electrical stimulator that could trigger muscle directly rather than via microscopic nerve branches. When the gadget was created, they had the idea that it could also activate the motor parts of the human brain via the intact scalp (transcranial electrical stimulation [TES]), and it worked. An electromagnetic coil is positioned against your scalp near your forehead during an rTMS session. The electromagnet produces a magnetic pulse that activates nerve cells in the part of your brain that controls mood and depression. It’s believed to activate brain areas that are less active in those who are suffering from depression.
TMS: a cure for neuropathic pain
“Neuropathic pain” is defined as chronic pain produced by illnesses or injuries that affect peripheral or central pain-sensing neural circuits, leading them to fire wrongly and suggest pain without cause. Neuropathic pain is very prevalent, and it can make diabetes, shingles, HIV, and cancer worse. Better ways are needed because medications are frequently ineffective or cause numerous side effects. Electrical stimulation of specific areas of the brain (neuromodulation) was shown to cure refractory NP without remote effects half a century ago, but deep brain stimulation was limited due to the need for surgical electrode placement. The motor cortex was stimulated by electrodes placed on the dura outside the brain’s surface, which was demonstrated to relieve NP less invasively. Using transcranial magnetic stimulation and electromagnetic induction, cortical neurons can now be stimulated completely non-invasively (TMS). Neuronal plasticity can be triggered by repeated sessions of numerous TMS pulses (rTMS), resulting in a long-term therapeutic effect. Repeated TMS has already received regulatory approval in the United States and Europe for the treatment of resistant depression, and many small studies have shown efficacy for neuropathic pain. Patients’ head MRIs allow TMS to be administered to specific underlying cortical targets, limiting fluctuation between treatments and patients, which may improve efficacy. Transcranial magnetic stimulation appears to be on track for the larger trials required for an NP indication to be approved by the FDA. We examine TMS’ theoretical foundation and historical evolution, summarise the neuropathic pain trial outcomes, and identify difficulties to fix before large-scale clinical trials because few practitioners are familiar with it.
Treating depression with the Transcranial magnetic stimulation.
In the United States, depression is the biggest cause of disability among those aged 15 to 44. While there are numerous successful therapies for depression, medications and psychotherapy do not work for everyone. In fact, almost two-thirds of people with depression don’t obtain enough relief from their initial antidepressants. For these people, at least some symptoms will persist after two months of treatment, and each subsequent medicine will be less likely to assist than the one before. Electroconvulsive therapy (ECT or “shock therapy”) has been the gold standard for treatment-resistant depression for decades. In fact, ECT is still regarded as the most powerful and efficient treatment for this ailment, and it is still widely utilised across the country. However, due to its negative effects on memory and cognition, ECT can be too difficult to bear for many persons with depression. There is a newer therapeutic option called transcranial magnetic stimulation for those people and the many others who have had an insufficient response to drugs and therapy alone (TMS). TMS therapy is a time-consuming treatment that requires five treatments each week for several weeks. Depending on the equipment and clinical protocol employed, each session can take anywhere from 20 to 50 minutes. Patients may check in with a specialist or physician momentarily before beginning the stimulation process. Using the motor cortex as a “landmark” in the brain, the technician will determine the optimal stimulation intensity and anatomical target. The team can establish where to best place the stimulation coil in relation to that individual’s brain and how intensely it must “fire” in order to generate optimal stimulation by first targeting this portion of the brain. The dorsolateral prefrontal cortex, the brain target with the most evidence of clinical success and an area believed to be involved in depression, is then identified using calculations. Though one session may be enough to improve the brain’s excitability level, relief usually doesn’t appear until the third, fourth, fifth, or even sixth week of treatment.
Reference
- Hallett, M. (2007). Transcranial Magnetic Stimulation: A Primer. Neuron, 55(2), 187–199.
https://doi.org/10.1016/j.neuron.2007.06.026 - MD, A. P. S. (2018, February 23). Transcranial magnetic stimulation (TMS): Hope for stubborn depression. Harvard Health.
https://www.health.harvard.edu/blog/transcranial-magnetic-stimulation-for-depression-2018022313335 - Transcranial magnetic stimulation—Mayo Clinic. (n.d.). Retrieved May 9, 2022, from
https://www.mayoclinic.org/tests-procedures/transcranial-magnetic-stimulation/about/pac-20384625 - Treister, R., Lang, M., Klein, M. M., & Oaklander, A. L. (2013). Non-invasive Transcranial Magnetic Stimulation (TMS) of the Motor Cortex for Neuropathic Pain—At the Tipping Point? Rambam Maimonides Medical Journal, 4(4), e0023. https://doi.org/10.5041/RMMJ.10130
- Yang, S., & Chang, M. C. (2020). Effect of Repetitive Transcranial Magnetic Stimulation on Pain Management: A Systematic Narrative Review. Frontiers in Neurology, 11. https://www.frontiersin.org/article/10.3389/fneur.2020.00114