TMS for MDD Overview: A Comprehensive Guide

Transcranial Magnetic Stimulation (TMS) therapy for Major Depressive Disorder (MDD) is a structured process designed to be efficient, safe, and comfortable for the patient. Below is a step-by-step guide outlining what patients can expect during the course of treatment, focusing on the equipment used, treatment timelines, and aftercare.

1. Initial Consultation

The TMS treatment journey begins with a consultation with a psychiatrist or a trained healthcare professional. During this session:

• The patient’s medical history and past treatments are reviewed.
• The psychiatrist determines whether the patient meets the criteria for TMS (e.g., failed response to at least one antidepressant).
• Expectations, side effects, and the overall process are discussed.

2. Mapping Session: Finding the Motor Threshold (MT)

Before starting treatment, a motor threshold (MT) mapping session is conducted to calibrate the equipment. The motor threshold helps customize the TMS treatment for MDD. This involves:

• Placing the TMS coil (such as the Blossom TMS device’s quiet coil) over the scalp to locate the area of the brain responsible for controlling hand movement.
• By stimulating this area, the doctor observes minimal muscle contractions in the patient’s hand or fingers. The lowest magnetic pulse intensity that causes these contractions determines the patient’s motor threshold.
• The motor threshold helps customize the TMS treatment intensity for each patient, ensuring effectiveness and safety.

3. Beginning the Treatment Course

Once the motor threshold is set, the treatment process starts. Here’s what patients can expect:

• Treatment Sessions: TMS treatment for MDD typically consists of 20-30 sessions, administered five times a week over a period of four to six weeks. Each session lasts around 20 to 40 minutes.
• Equipment Used: The Blossom TMS device is equipped with a liquid-cooled coil to maintain comfort during prolonged sessions. It operates quietly, minimizing noise, and ensures a smooth experience.
• Procedure: During each session, the patient sits comfortably in a chair. The TMS coil is positioned over the left dorsolateral prefrontal cortex, the area linked to mood regulation.
  

  • Patients feel a tapping sensation on their scalp and hear a clicking sound as the magnetic pulses are delivered.
  • The treatment is non-invasive, and patients remain fully awake and alert throughout the procedure.

4. What Happens During Each Session?

• Stimulation Phase: Once the session begins, the TMS device delivers magnetic pulses in short bursts, stimulating the targeted brain region. Patients may experience:
  

  • Mild discomfort or tapping sensations on the scalp.
  • Muscle contractions in the face or jaw, though this is typically brief.

• Monitoring: Clinicians are present to monitor the patient and ensure they are comfortable. Adjustments to the coil position or intensity may be made if necessary.
• Duration: Sessions last approximately 20-40 minutes, depending on the protocol and machine settings. The Blossom TMS system allows for smooth, continuous operation, reducing discomfort from heat buildup thanks to its quiet coil and cooling technology.

5. Aftercare and Post-Treatment

• Immediately After Each Session: Patients can immediately return to their daily activities, as no sedation or recovery time is needed. Side effects, if any, are typically mild and temporary. These might include:
  

  • Mild headache
  • Scalp discomfort at the site of stimulation
  • Slight dizziness or light-headedness

• Long-Term Aftercare: After the full course of TMS treatment, patients typically have a follow-up consultation to assess their progress and determine if further sessions are required.
• Maintenance Sessions: Some patients may require maintenance TMS sessions in the future if depressive symptoms return. These sessions are typically less frequent, but they help prolong the therapeutic benefits of TMS.

6. Monitoring Progress

Throughout the treatment, patients’ progress is monitored by mental health professionals. Common assessments include:

• Self-reporting tools: Patients may be asked to fill out questionnaires (like the PHQ-9 or MADRS) to measure changes in their depressive symptoms.
• Clinical assessments: Psychiatrists may conduct periodic evaluations to adjust treatment if necessary.

7. Summary

The TMS treatment process for MDD is structured, effective, and relatively simple for patients. Using advanced devices like the Blossom TMS system, which is equipped with patient-friendly features such as quiet operation and effective cooling, patients can experience minimal discomfort and disruption to their daily lives. By the end of a standard 4-6 week course, many patients report a significant reduction in depressive symptoms