MORGANTOWN, W.Va. – WVU Medicine is now offering an option for patients with treatment resistant depression. Transcranial magnetic stimulation, or TMS, is a noninvasive form of brain stimulation that targets the dorsolateral prefrontal cortex, which is connected to the deeper circuits of the brain responsible for depression.
“What makes TMS unique is that it's non-pharmacologic so it's not a medication,” Patrick Marshalek, M.D., WVU Rockefeller Neuroscience Institute vice chair of clinical inpatient operations and TMS clinical director, said. “You don't have to take a pill every single day, so that frees you up from any potential side effects related to that.”
Historically, medications for depression have all tried to increase levels of monoamines such as serotonin, norepinephrine, and dopamine. However, these medications may not work for everyone. Some patients don't benefit from medication therapies and continue to suffer from the effects of depression. TMS can provide another option for these patients because it works through a physical mechanism, not a pharmacologic mechanism.
Patients undergoing the procedure sit in a comfortable chair and a cap is placed on their head. An electromagnet is moved over the patient’s head until the motor strip is identified by movement in the patient’s thumb or arm. The electromagnet is then moved forward over the dorsolateral prefrontal cortex in order to stimulate the nerve cells.
“If we can stimulate that specific region of the brain, the hope is we can bring that and other regions of the brain that are associated with mood back online and improve the patient’s symptoms,” Marshalek said. “Some patients see improvement after their first TMS session, opposed to the four to six weeks that is normal with drug therapies.”
According to Marshalek, TMS can sound intimidating to some patients, but it presents very little risk.
“I think the most important thing with TMS is to not be afraid of it,” Marshalek said. “It can seem kind of scary at first to be sitting in a chair having an electromagnetic coil exciting part of the brain, but at the end of the day, it is very safe and it presents an option for patients who haven’t benefited from other treatments. We treat the sickest patients in the state here at WVU Medicine and it is an incredible opportunity to be able to offer this treatment to those who have exhausted other options.”