Transcranial Magnetic Stimulation (TMS) is a medical breakthrough in understanding and treating the brain. This innovative therapy, which has been in development since the 80s and received FDA approval in 2008, targets specific parts of the brain for stimulation. These brain areas are associated with depression, bipolar disorder, post-traumatic stress disorder, and chronic pain, among other conditions. The neurons fire when exposed to a magnetic field as your brain is spurred into activity.
TMS is effective at making significant, long-lasting improvements in mental health that endure through the years. Recently, TMS has been compared to another medical procedure that targets the brain, electroconvulsive therapy (ECT). However, the two could not be more different. The similarities start and end with the fact they both rely on electricity. ECT is an extreme solution to a severe problem, a medical last resort, whereas TMS has broad applications and can be part of a holistic therapy regime.
At Integrative Health Centers, we are experts in mental health and overall wellness. This article will compare the two procedures and how they can help, or hinder, a person’s well being.
How TMS and ECT Work
Modern TMS works like an MRI, with a state-of-the-art helmet producing a magnetic field for targeting specific brain parts. For example, the prefrontal cortex would be the subject of magnetism if the therapist was hoping to address depression since that area controls emotions. The voltage can be a maximum of 250 volts (for comparison, 120 volts is the standard for an American electrical outlet). However, this electricity is not directly administered to the brain but used to generate a magnetic field in a few centimeters of brain matter. Therefore, the patient does not feel pain.
ECT is the opposite of this. It is an in-patient procedure that requires general anesthesia to perform. Electrodes are placed on the sides of the head, and electricity with a voltage of 180-480 is passed through them directly into the brain for milliseconds or seconds. The explicit goal is to trigger a seizure in the patient, but individuals have different thresholds for seizures. This idiosyncrasy means that the shock must be calibrated, sometimes by trial and error, until it can induce a seizure.
The Intrusiveness of TMS and ECT
TMS is a non-intrusive procedure. The sessions last under half an hour a few times a week for 4-6 weeks. It is an outpatient procedure and requires no medication. The patient feels no discomfort and, instantly after a session, they can continue their day’s regular schedule. It is no more burdensome than a routine medical checkup, and the worst reported side effects are non-permanent headaches in a small percentage of those who undergo the therapy.
ECT also requires several weekly sessions for 4-6 weeks, but it requires hospitalization. This requires a lot of downtime, as a patient must recover after a session. A seizure is a severe brain reaction from electrical overstimulation, which can severely impact cognition. Patients most frequently report confusion, fogginess, loss of appetite, nausea, or muscle pain. However, more extreme side effects are possible and can permanently impair cognitive ability.
Cognitive Ability Decreases in ECT and TMS
ECT can cause severe impairment in a range of mental abilities that patients are often unprepared to handle. The first of these is amnesia, both retrograde and anterograde. The former is forgetting old memories, and the latter is the inability to form new ones. This electroconvulsive-induced memory loss can be long-lasting. Those subjected to the treatment have forgotten vital information about their relationships and careers while reporting they can’t retain new information. Repeated studies utilizing a diagnostic questionnaire called the Columbia University Autobiographical Memory Interview have found that ECT patients forget many significant life events and can’t remember them even when prompted with information.
Memory is not the only mental process that ECT harms. It can also impact intelligence, fluid thinking, creativity, and other cognitive abilities. On a series of cognitive tests, ECT patients score consistently lower. One study even revealed that ECT lowered IQ scores by 30 points or more, two standard deviations overall. For reference, about 2% of people have an IQ of 130. If subjected to CTE, their performance on subsequent tests would be at 100, meaning they would go from scoring above 98% of the population to being completely average.
TMS has the opposite effect. Since it spurs neurogenesis, meaning the creation of neurons, it has been shown to improve recall abilities. These regenerative abilities are why TMS is used to treat elderly Alzheimer’s patients and manage their condition. Another possible effect of ECT is apathy; the world dulls for someone who receives repeated electric shocks to their brain and can no longer feel the full spectrum of emotion or take a sustained interest in things. No such behavioral aberrations are seen with TMS.
Positive Aspects of TMS
TMS has seen success in treating many conditions, particularly medication-resistant depression. One study reported that 3 out of 4 patients reported their mood improving, and 51% reported remission, meaning their condition was treated entirely. TMS can be taken with medication, but it can also work perfectly without allowing patients to ditch their antidepressants and live without their side effects. Despite being new compared to ECT, it’s covered by most major medical insurance providers.
TMS was built upon the principles of using electricity to treat the brain that ECT brought to the mainstream. It represents an evolution of that old treatment. It continues to evolve, with Deep TMS Therapy being a more advanced form that consistently produces better effects.
Integrative Healthcare Center and TMS
Battling mental issues significantly strains your wellness and the lives of those around you. Integrative Healthcare Center is here to help. We don’t focus on just addressing your symptoms but treating you as a whole person deserving of dignity and holistic wellness. We offer conventional treatments like psychotherapy and medication-assisted treatment, in addition to more innovative techniques like TMS, biofeedback therapy, nutritional guidance and meditation.