Typical TMS Treatment
Transcranial Magnetic Stimulation (TMS) Therapy
Why deep TMS?
The prefrontal cortex is not thick, only about 2 millimeters, however it is not uniformly distributed on a sphere like surface of this type (see red surface on the right for reference). Instead, its surface is irregular and has deep trenches named sulci that can be much deeper than the typical depth acquired by a figure of 8 coil (rTMS) (see green surface on the right for reference) Deep inside these sulci, dTMS is able to stimulate the brain cells but rTMS is unable to reach a significant threshold value. Thus, dTMS is able to stimulate more neurons than rTMS and therefore to exercise a larger effect on the deeper brain structures involved in depression.
Pre TMS Procedure
Dr Ghelber will talk to you in detail taking a medical and psychiatric history and establishing if dTMS is indicated for you. She will also discuss with you what you are going to feel during the procedure, possible counter-indications, medication adjustments and treatment protocols. You will also have an interview with Kumud that will go over your insurance papers and will help you understand the chances of getting an approval from your insurance company. He will schedule you for the initial treatment session and the subsequent sessions.
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During the TMS Procedure
Please be patient for the first treatment since this will be a longer one. The position of the stimulating helmet (magnetic coil) and the intensity of the stimulus need to be adjusted specifically for you. Subsequent treatments will be of shorter duration ( typically 20 minutes), however various treatment protocols of different duration are available. During the treatment, as deemed necessary by Dr Ghelber, the intensity of the necessary magnetic stimulus and the position of the coil will be reassessed.
Post TMS Procedure
Once the TMS session ends, we will remove the helmet you had to wear for the procedure and you are free to go on with you daily routine No side effects are to be expected at this time, however please inform us of any concern you may have At this time you may go to the front desk and schedule your next appointment.
- Side effects should subside completely post procedure .
- You will be able to go about your normal routine.
- If you drove yourself to the office you will be able to drive home.