The first step in the TMS treatment process is determining whether or not TMS is an appropriate treatment for you. This is done in a consultation with Dr. Hayden, who will review your symptoms, treatment history, and possible treatment options. Cindy Duvall RN, our TMS Coordinator, is also available for a prescreening, prior to seeing Dr Hayden. When you contact the office, our staff will schedule this evaluation, which will last about an hour.
Your first treatment session
If TMS is right for you, an initial treatment session will be scheduled. At this first visit, which may last over an hour, Dr. Hayden will determine the appropriate placement and energy settings. Placement of the treatment coil and the strength of the magnetic field are important factors in successful TMS treatment. In order to do this, a test is done to determine what is called the motor threshold. A magnetic pulse will be repeatedly given to find the strength that is just enough to result in a movement of your right hand. From there, the coil is moved forward to a specific area over the left frontal lobe, and the energy levels are increased.
The actual treatment session lasts about 20 minutes. As you sit reclined, awake and alert, the TMS System delivers 40 rapid MRI strength magnetic pulses over 4 seconds. The pulses make a loud clicking sound, and ear protection or ear plugs are required. The pulses feel like a tapping on the scalp but without the sensation of anything touching the skin. The same 4 second sequence is repeated 75 times every 11 seconds. During the session you can watch television, listen to music, or simply sit back and relax.
After the procedure
After the treatment, you can drive and resume your normal day. TMS is non-invasive, meaning it does not involve surgery, and also non-systemic, meaning no drugs are used, and therefore no drug side effects. Typical TMS side effects are irritation or discomfort at the treatment site, or headache, and are usually mild.
Treatment sessions are then repeated by our trained TMS staff each day using the settings initially determined by Dr. Hayden. A usual course of treatment involves sessions 5 days a week for 4 to 6 weeks, although this can vary depending on a patient’s response to treatment. A tapering set of treatments is sometimes used to to allow the brain to take over its role after intermittent sessions. As you progress through your therapy, Dr. Hayden, and the TMS staff will regularly assess your progress and determine the eventual number of treatments.