Transcranial magnetic stimulation (TMS) is an increasingly popular, evidence-based treatment for depression and other conditions. With this treatment now being offered by NeuroCentrix at The Banyans Medical Centre, we brought together local GPs and psychiatrists at our Bowen Hills facility to learn more about this treatment and how it is helping patients.
Electrical signals travel through our brains to generate what we experience as thoughts and emotions. With each signal, the pathway it takes becomes a little stronger, and the neurons that fire become more likely to fire again. Like a well-worn path through a forest, or the course a river carves through the landscape, our brain signals shape their own highways. This is the basis of how we learn and form habits.
Unfortunately, during depression, repeated negative thoughts and feelings strengthen the pathways that make further negative thoughts and feelings more likely. That is why depression often seems to take on a life of its own, and formerly enjoyable experiences lose their lustre. Things seem even worse than they really are, and thinking positively becomes ever harder.
We can actually see this phenomenon during functional MRI scans. The limbic system – home to fear and sadness – appears overactive, while the frontal lobe – which usually dampens these feelings – appears quiet.
What TMS does is deliver mild electrical impulses through the regions subdued by depression to both reawaken and strengthen them. A coil placed lightly against the scalp produces magnetic fields which induce mild currents through these targeted areas of the brain. A single TMS session can stimulate pathways in the frontal lobe 3,000 – 5,000 times. Strengthening these pathways then dampens the overactive limbic system, and together these effects produce lasting clinical benefit.
Since its introduction in the 1980s, TMS has been most thoroughly studied in patients with treatment-resistant depression, depression that has defied two full courses of different classes of antidepressant. This category of depression is the most difficult to treat, yet TMS has shown remarkably positive results. TMS therapy is effective because it subtly corrects the neural pathways that underlie depression, as well as boosting levels of deficient neurotransmitters.
One study of patients who completed TMS depression treatment showed that a year later, 68% were still improved, and 45% had no symptoms. Another study was even more encouraging, with almost two thirds of patients showing no symptoms of depression a full year after treatment.
There are generally two pathways to accessing TMS – Medicare eligibility for treatment-resistant depression and out-of-pocket options.
The first pathway is through the Medicare system. This pathway is available for patients aged 18 and above who have tried at least two classes of antidepressants, remain unwell and have not previously received TMS treatment.
The second pathway is for patients who want to consider TMS without the Medicare funding. This pathway is available upon referral from a GP or psychiatrist. Through this pathway, TMS may also be available for other conditions including PTSD, anxiety and OCD.
I am a patient
To start the process, ask your GP or psychiatrist to send us a referral for TMS. They can submit the Referral Form on the NeuroCentrix website here. Once we process the request, we will arrange for you to attend an initial consultation with one of the NeuroCentrix psychiatrists to assess your suitability for TMS therapy. If you meet the Medicare eligibility criteria and the psychiatrist thinks TMS will be of value to you, we will book you in to commence TMS treatment. If TMS is not suitable, we will provide comprehensive recommendations for alternative treatment options to your referrer.
I am a treatment professional
To make a referral for your patient to receive TMS, please complete the Referral Form on the NeuroCentrix website here. From there, one of the NeuroCentrix Concierge Team will contact your patient the same business day to arrange the best available consultation appointment.