What is RTMS
RTMS is a technology based on creating a magnetic pulse. When you pass electricity through a metal coil. It is not the electricity that stimulates the body, it is the magnetic pulse that stimulates the cells. In this case, we use it to stimulate nerves or nerve cells that have been deactivated either by a depressed function or a damaged structure. For example, in stroke rehabilitation, you have the damage to the structure and in conditions like depression, you have a depression of the function and what rTMS does is not only stimulates the nerves to work again, but it recreates the nerve pathways again. We call that a neuroplastic effect.
Use for depression
RTMS is used to treat many conditions. RTMS works where drugs fail and work as well as a replacement of drugs whereby if people don’t want to have drugs or cannot have drugs for whatever reason, whether they’re pregnant, breastfeeding, allergies to drugs, can’t tolerate side effects, rTMS comes in very useful.
Useful for Migraine
Another condition where it’s recommended by NICE is migraine. rTMS cuts the attack short and not only that but can be very useful in prevention of migraine attacks.
Use in other conditions
Other conditions where rTMS is very useful are things like stroke rehabilitation, Parkinson’s disease. You’ll also get improvement in gait, movement, fluidity of movement. In things like Alzheimer’s disease. You’ll get improvement in memory. In chronic schizophrenia, you’ll get improvement in memory. While in pain syndromes, it reduces pain perception. For Cases of fibromyalgia and chronic fatigue syndrome, they find that it improves quality of life and pain parameters regardless of the improvement of mood. All of this is very encouraging.
Certainly, we’re looking for more applications to use this conditions particularly there has no harm and no side effects. RTMS works by delivering a physical pulse that people feel like a tap. People feel that physically in the head but interestingly, that tap penetrates the skull, goes through the other side and physically stimulates the brain as if you touch the brain with a magnetic field. That tap stimulates the blood flow and the neuron electivity in the nerve cells whereby the cells start to communicate more, more blood flow, more activity, more glucose utilisation, and that restores the function of the cell. What you have from thereon is the neuroplastic effect whereby the repeated stimulation and the activation of nerve cells helps to create new pathways in the brain. That will allow the cells to work for longer time and for that to be sustainable. For example, when they looked at the recovery rates of depression with rTMS versus medication or electrocompulsive treatment whilst with medication, this figure was 13% and with ECT it was 30%.
It is clear that rTMS effects are long lasting as opposed to those with medication or ECT. rTMS is effectively suitable for everybody except with those with a history of seizures which is uncontrollable.
Cautions and Side Effects
If you have a seizure disorder, epilepsy, which has failed to respond to treatment or you’ve had active seizures before, or resistance seizures before, then rTMS may not be the best treatment for you because it could aggravate the seizures. Although the seizure risk with rTMS is far below the seizure risk you get with medication for depression. Other patients would be suitable for others who don’t want to take drugs, those in whom drug treatments fail, those who cannot tolerate drugs have side effects from drugs whether metabolic or physical or sexual side effects, weight gain, all these side effects will cause people to want to come off their drugs. Also, it would be suitable for women who are pregnant or for women who are breastfeeding because you don’t get any interference with the development of the foetus. It is too distant from the magnetic field. You don’t get any interference with breast milk production.
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