Tech & Innovation in Healthcare

TMS has the potential to treat several mental health conditions.

According to a Centers for Disease Control and Prevention (CDC) survey published in 2020, approximately 9.1 million American adults experienced symptoms of severe depression in a two-week period. For some patients with severe depressive disorders, medications or therapy are ineffective, but transcranial magnetic stimulation (TMS) may offer relief.

Check out how researchers are studying the effect of TMS on major depression and other mental health conditions.

What Is Transcranial Magnetic Stimulation?

TMS is a noninvasive procedure that uses electromagnetic induction to stimulate the brain’s nerve cells to improve certain functions. The equipment discharges a large current making a quickly fluxing magnetic field that penetrates the patient’s scalp and skull to help ensure the current is large enough to force the brain’s surface neurons to fire.

Several studies have found that TMS can alter certain brain functions, including regions of the brain that feature decreased activity due to depression. Cleared by the Food and Drug Administration (FDA) in 2008, TMS is an ideal treatment for depression when the patient doesn’t respond to standard treatments, such as medications and talk therapy.

Manage Depression When Medications Miss the Mark

TMS is a suitable treatment option for patients with depression. Researchers at the University of California San Diego (UCSD) School of Medicine have primarily focused their studies on treatment-resistant unipolar depression (TRD) and continue to examine the efficacy of TMS for depressive disorders.

TRD is unipolar depression where the patient isn’t responding to treatment. Unipolar depression, also known as major depressive disorder, is a mental health condition that affects both the patient’s physical and mental health.

Cory R. Weissman, MD, assistant clinical professor and medical director of interventional psychiatry at UC San Diego Health in San Diego, California, considers TMS to be a great treatment option for patients with TRD who don’t respond to or cannot tolerate traditional antidepressant medications. “We see response rates of approximately 60 percent and remission rates of approximately 30 percent in this population, which is great,” Dr. Weissman says.

While TMS has been FDA approved for 14 years, researchers at UCSD are exploring other conditions where TMS could be beneficial. “While our main focus is on TRD, we will also be conducting studies in bipolar depression, traumatic brain injury (TBI), and suicide prevention,” says Dr. Weissman. He added that UCSD researchers will be adapting the recent advances in understanding brain connectivity, such as in electroencephalography (EEG) and neuroimaging.

Learn how UCSD researchers are examining TMS effectiveness with the following clinical trials:

Bipolar depression clinical trial: UCSD researchers are evaluating whether a form of repetitive transcranial magnetic stimulation (rTMS) can help significantly reduce depressive symptoms. The subjects for this study are between 18 and 70 years old with bipolar depression symptoms who have failed at least two previous treatments.

Traumatic brain injury clinical trial: Chronic headaches are one of the most common symptoms military personnel suffer from following a mild TBI. UCSD researchers are conducting a clinical trial to examine the effectiveness of rTMS in treating mild TBI-related headaches for two to three months.

Suicide prevention clinical trial: During the suicide prevention clinical trial, researchers are exploring the effectiveness of bilateral rTMS on preventing suicidal ideation (SI).

UCSD researchers will also be exploring “different treatment schedule paradigms of TMS,” which include accelerated protocols. These accelerated protocols would involve 10 treatments per day over five days as opposed to standard treatments, which consist of five sessions per week over four to seven weeks.

Collaborative Efforts With Other Schools

According to a CDC Morbidity and Mortality Weekly Report from April 2, 2021, the percentage of adults experiencing recent symptoms of anxiety or a depressive disorder increased from 36.4 to 41.5 percent from August 2020 to February 2021, and the COVID-19 public health emergency (PHE) has highlighted the need for mental health services.

In February 2022, researchers at UCSD School of Medicine, Weill Cornell Medicine, and Stanford Medicine announced a three-year collaborative study to examine new methods to “treat or prevent major depression, accelerate application of effective treatments and develop predictive models to identify which treatments may work best for individual patients.”

The collaboration is part of a $50 million effort by Wellcome Leap, which helps fund alternative projects with complex human health needs in mind. During the multi-year study, participants will receive different treatments, which include medications and different types of TMS. Ultimately, the goal will be to match personalized treatment plans to suit the needs of each individual patient.

What Does the Future Hold for TMS Treatments?

TMS also has the potential to show promise in treating conditions other than depression. “We are cautiously optimistic that TMS could be useful in many conditions that, like depression, have some basis in cortical brain disturbances,” Dr. Weissman says. In addition to TBI, suicide prevention, and bipolar disorder, as described above, researchers may look to positive symptoms of psychotic illness, tinnitus, and eating disorders as future approved targets.