TMS targets the activity of nerve cells in your brain, which may help with depression and other mental health conditions. It may also help people with neurological disorders like Parkinson’s or multiple sclerosis.

Transcranial magnetic stimulation (TMS) is a type of brain stimulation therapy.

This article will cover what TMS is, who it may help, and the possible benefits and risks.

TMS is a noninvasive treatment that uses electromagnetic pulses to stimulate nerve cells. Since TMS uses repetitive electrical impulses, it’s sometimes called repetitive transcranial magnetic stimulation (rTMS). The terms are often used interchangeably.

It may improve symptoms of neurological or mental health disorders.

Conditions that TMS may help include:

  • depression
  • OCD
  • anxiety
  • post-traumatic stress disorder (PTSD)
  • motor dysfunction due to Parkinson’s disease, multiple sclerosis, or stroke

TMS is FDA-approved to treat depression. It has had success helping people who don’t respond to antidepressant medication and psychotherapy.

There’s also some evidence that TMS may help other conditions, like anxiety and Parkinson’s disease.

A TMS technician or doctor performs the therapy session as an outpatient procedure. This means it may be done in a medical clinic. If it’s done in a hospital, you won’t need to stay overnight.

Before the procedure, you’ll need to remove items that are sensitive to magnets, like jewelry.

Here’s what you can expect during TMS:

  1. Your technician will have you wear earplugs to minimize the clicking sound of magnetic impulses. They’ll have you sit in a comfortable chair. You won’t need general anesthesia, and you’ll be awake throughout the treatment.
  2. If it’s your first session, your technician will measure your head to determine where to place the magnetic coil. They’ll also take other measurements to personalize the settings on the TMS machine.
  3. Your technician will place the coil above the front area of your brain. Next, they’ll start the treatment.
  4. You’ll hear a clicking sound as the magnetic impulses are released. You’ll also feel a tapping or knocking sensation beneath the magnetic coil.
  5. The treatment can last 30 to 60 minutes. You can drive yourself home after the procedure and resume your usual activities.

You’ll need to repeat the procedure 5 days a week for about 4 to 6 weeks. The exact length of your treatment depends on your response and specific condition.

There are many possible benefits of TMS therapy. Researchers are still studying the procedure, but it may help the following conditions:

TMS therapy for depression

TMS is primarily used to treat major depressive disorder (MDD).

It’s generally recommended for those who haven’t found relief from medication and psychotherapy. This is called treatment-resistant depression. Approximately 30% of people with depression don’t respond to typical treatments.

Research from 2021 suggests depression is linked to reduced activity in the prefrontal cortex. This part of the brain is involved with depression symptoms, like low energy levels and appetite changes.

TMS may help by stimulating nerve cells and increasing activity in this area.

TMS therapy for obsessive-compulsive disorder (OCD)

TMS may improve symptoms of obsessive-compulsive disorder (OCD).

The FDA approved TMS for OCD in 2018. As with depression, TMS is recommended if a person with OCD hasn’t responded to medication and psychotherapy.

According to one study, people with OCD often have increased activity between the prefrontal cortex and striatum. This hyperconnectivity is associated with severe OCD symptoms.

TMS can be used to inhibit the activity in this part of the brain, reducing OCD symptoms.

While TMS has shown promise in treating OCD, it’s still not widely accepted in the medical community and may need more research on how to effectively use it.

TMS therapy for anxiety

As TMS treats psychological disorders like depression and OCD, it may also ease anxiety. That’s because these conditions often cause anxiety symptoms.

TMS could also be beneficial for generalized anxiety disorder (GAD).

There’s often increased nerve cell activity in the prefrontal cortex in people with anxiety. According to a 2021 research review, TMS may reduce the activity in this region.

TMS for post-traumatic stress disorder (PTSD)

According to a 2019 research review, TMS showed effectiveness for post-traumatic stress disorder (PTSD). TMS can target the prefrontal cortex, which regulates how you process fear and worry.

A 2018 clinical trial found that TMS, alongside cognitive processing therapy, was effective for PTSD. The therapeutic effect of this combination lasted 6 months.

TMS for stroke rehabilitation

A stroke occurs when blood flow to the brain is blocked or reduced, causing brain cells to die. This can cause long-term loss of muscle movement.

Using TMS after a stroke could promote motor recovery. Researchers suggest that magnetic impulses may alter the activity of the motor cortex, the part of the brain that controls voluntary movement.

A 2017 journal article also shares that TMS may improve difficulty swallowing after a stroke by stimulating the motor cortex.

TMS for schizophrenia

Schizophrenia is a chronic and often severe psychiatric disorder.

A main symptom of the condition is auditory hallucinations, which affect 75% of people with schizophrenia.

Targeting the temporoparietal cortex may be beneficial for auditory hallucinations. This part of the brain, which is involved in language, is typically overactive in people with schizophrenia.

TMS for Parkinson’s disease

Parkinson’s disease is a neurological disorder that causes motor dysfunction, including:

  • tremors
  • balance issues
  • freezing of gait, which occurs when you feel frozen and can’t move while walking

A 2020 study found that TMS may improve freezing of gait. According to the researchers, TMS normalized the connections between parts of the brain involved in gait freezing.

TMS for Alzheimer’s disease

TMS might have benefits for Alzheimer’s disease, a form of dementia. This condition causes progressive memory loss and cognitive decline.

According to 2020 research, TMS may help Alzheimer’s disease by altering the neural connections involved in memory and learning. However, more research is necessary to understand how TMS can manage Alzheimer’s disease.

A 2023 review of research suggests it may help with symptoms of both Alzheimer’s disease and mild cognitive impairment.

TMS for chronic pain

TMS could potentially improve chronic pain conditions, such as fibromyalgia. A 2017 analysis notes that it may help by stimulating the motor cortex and controlling neurotransmitters involved in pain.

It’s worth noting that depression and chronic pain often occur together. Depression can worsen chronic pain, so TMS may also help by treating depression symptoms.

TMS for nicotine addiction

Nicotine releases dopamine, also called the “happy hormone.” It sends signals to the reward system of your brain, including the prefrontal cortex, resulting in nicotine cravings and addiction.

A 2021 study determined TMS could help reduce nicotine cravings by targeting the prefrontal cortex.

TMS may also promote the release of dopamine, which reduces the need for nicotine.

TMS for multiple sclerosis

Multiple sclerosis (MS) is a chronic autoimmune disorder that affects the nervous system. It commonly causes muscle tightness (spasticity) that makes it difficult to move.

In a 2019 study, researchers used TMS on the motor cortex of people with MS. The treatment, combined with physical therapy, decreased spasticity.

To date, TMS therapy has mostly been studied as a treatment for depression.

The success rate of TMS for depression is promising. Response rates for depression are between 30% and 64%.

More research is needed to understand the success rate for other medical conditions.

If you have depression, a doctor will likely recommend antidepressants and psychotherapy before TMS.

However, you may be a good candidate for TMS if you:

If you’re young, TMS might be an ideal choice. That’s because younger people are more likely to develop adverse side effects from antidepressants.

TMS is considered safe, but it’s not for everyone.

You should avoid TMS if you have metal in your head, such as:

  • deep brain stimulators
  • electrodes
  • neck or brain stents
  • aneurysm clips or coils
  • shrapnel or bullet pieces
  • facial tattoos with metallic ink
  • metal plates
  • cochlear implants
  • permanent piercings

The magnetic fields in TMS can make these implants heat up or move, which can cause serious injuries.

It’s OK to get the treatment if you have braces or dental fillings.

You may also need to avoid TMS if you:

  • have a history of epilepsy or seizures
  • are taking stimulants
  • have a medical condition that increases the risk of seizures

TMS side effects are uncommon. If complications or side effects do occur, they may include:

  • mild headaches (most common)
  • lightheadedness
  • scalp pain
  • neck pain
  • tingling
  • facial twitching
  • sleepiness
  • altered cognition during treatment

Symptoms like headaches and lightheadedness usually go away after several treatments.

There’s also a risk of seizures, but this side effect is rare.

According to a 2009 study, one course of TMS can cost between $6,000 and $12,000 out of pocket. Prices may have increased since then.

Your health insurance provider might offer coverage, but this depends on your medical history. You may be required to try at least four antidepressants before receiving TMS coverage.

Alternatively, they might provide coverage if you experience negative reactions when using antidepressants.

Is TMS therapy covered by Medicare?

If antidepressants and psychotherapy don’t work for you, Medicare will cover TMS therapy.

Do you have to miss work for TMS therapy?

Since you’re expected to get treatment 5 days a week for multiple weeks, you may have to miss a few hours of work each day. This depends on your schedule, the location of the clinic, and the time of your appointments.

One session can take anywhere from 30 to 60 minutes.

TMS targets the activity of nerve cells in your brain, which may relieve depression symptoms. It could also benefit people with conditions like OCD, anxiety, and PTSD.

The procedure may even improve motor dysfunction, making it potentially helpful for people living with Parkinson’s disease, multiple sclerosis, or during stroke rehabilitation.

If you’re interested in TMS, talk with a doctor. You may be a good candidate if you’re young, have a low risk of seizures, and haven’t felt relief from antidepressants.