Repetitive transcranial magnetic stimulation (rTMS) is a form of brain stimulation therapy. It uses magnetic pulses instead of electricity to activate parts of the brain. Developed in 1985, rTMS has been studied as a possible therapy for depression. It may also be applied for other neurological and psychological disorders, such as Parkinson’s disease, stroke, tinnitus, obsessive-compulsive disorder, and dystonia. In 2008, the U.S. Food and Drug Association approved rTMS as a treatment for patients with major depression who do not respond to antidepressants.

How rTMS Works

A doctor places an electromagnetic coil against a patient’s forehead near the area of the brain that regulates mood. The coil then passes magnetic pulses to a targeted part of the brain. This induces an electrical current in specific nerve cells. The procedure contrasts to electroconvulsive therapy (ECT), in which an electrical current is delivered throughout the brain.

A typical rTMS session usually lasts a little under an hour. A doctor delivers magnetic stimulation at set intervals throughout the session. Depending on a patient’s condition and the discretion of the doctor, the length, intensity, and time between intervals may vary to produce the best results.

Repetitive transcranial magnetic stimulation is a fairly new form of treatment. Doctors are still studying its effects. But, scientists believe the magnetic stimulation can reset brain wave frequencies to normal levels and improve symptoms of depression.

Who It’s For

Repetitive transcranial magnetic stimulation is usually recommended only after medication and psychotherapies fail to work. Doctors suggest at least one round of prescription antidepressants in combination with psychotherapy before exploring the possibility of rTMS.

The most qualified candidates for rTMS are depression patients who have not had success with other methods. Also, in these patients, other brain stimulation therapies might be too dangerous. Patients who are not in good enough health to undergo a procedure such as ECT might be better candidates for rTMS.

Patients with any sort of implanted medical device, such as a pacemaker, are typically not eligible for the treatment. If you have a history of epilepsy, you also may need to explore other options. As is the case with most brain stimulation therapies, pregnant women, children, and elderly people might not be candidates for rTMS.

Possible Side Effects or Complications

Clinical trials on the effectiveness of rTMS have shown mixed results. Because rTMS is one of the newer forms of brain stimulation therapy, long-term studies are not available yet. Although rTMS is considered to be the least invasive kind of brain stimulation therapy, it still poses risks. Possible side effects include:

  • a slight tapping or knocking sensation as the magnetic pulses are passed through bone
  • headache
  • scalp irritation or discomfort
  • twitching in facial or neck muscles
  • seizure
  • hearing loss
  • nausea
  • vision problems
  • mania

Serious side effects such as seizure and hearing loss are rare. But, it’s best to talk to your doctor if you’re concerned about the risks of rTMS.

What the Experts Say

In a 2008 study published in Experimental Neurology, Dr. Mark George and Dr. Frank Padberg note that rTMS may be a promising option for patients with depression.

“Repetitive TMS treatment might have a therapeutic benefit not only for major depression, but also for depression associated with neurological disorders, such as Parkinson's disease (PD) and stroke.”

George and Padberg also say that rTMS may be a better option than other forms of brain stimulation therapy. This is because it has a lower rate of adverse effects. And, the treatment does not negatively interact with medications commonly taken for depression.