TMS is a therapeutic method based on a magnetic field and the phenomenon of electromagnetic induction. This method achieves precise neuromodulation of the brain's bioelectrical activity through short magnetic pulses of power comparable to traditional magnetic resonance imaging. Currently, the most commonly used TMS treatment protocol is repeated series of magnetic pulses (rTMS, repetitive TMS) with a frequency of 10 Hz, which has an excitatory effect, and 1 Hz has an inhibitory effect. The TMS stimulator generates impulses that penetrate the brain tissue at a depth of approx. 3-4 cm, thus inducing the so-called depolarization current. In this way, the activity of the cerebral cortex is stimulated at the stimulated site, and - through transsynaptic modulation - the activity of adjacent brain structures is also modified. TMS increases the so-called neuroplasticity of the nervous tissue through the secretion of neuroprotective substances and neurotransmitters (such as serotonin) in the brain. Transcranial magnetic stimulation also stimulates the processes of creating new nerve connections.

Currently, the most commonly used TMS treatment protocol is a series of repetitive magnetic pulses (rTMS) with a frequency of 10 Hz, which has an excitatory effect, and 1 Hz, which has an inhibitory effect. A variation of TMS is TBS (theta-burst stimulation), in which impulses are given in the so-called triplets at 50 Hz. TBS allows shortening the therapy (the so-called accelerated iTBS, aiTBS) up to several days and is much better tolerated by the patient than standard protocols. Many areas of the brain can be stimulated, including the most popular so-called targets include the bilateral prefrontal cortex, premotor cortex, motor cortex, and Broca's area. The stimulation target and protocol details are determined directly with the doctor during the qualifying consultation.

Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT) is a unique, personalized TMS protocol developed under the supervision of Prof. Nolan Williams from the Brain Stimulation Lab at Stanford University in California. It is probably the most effective therapy for drug-resistant depression, achieving about an 80% remission rate confirmed by clinical trials. SAINT is a veritable marathon consisting in completing 50 iTBS sessions over five days (10 sessions per day, every 50 minutes). The total dose of TMS in this protocol corresponds to six standard therapies. What distinguishes the original SAINT protocol from other protocols is not only the use of a vast number of magnetic pulses in a very short time. The innovation lies in using special software to select the best stimulation site based on analyzing the so-called anticorrelation between the cingulate gyrus and the cerebral cortex. Functional magnetic resonance imaging (fMRI) is used for this. This software has been patented by the American company Magnus Medical as The SAINT® Neuromodulation System and in 2022, officially received US FDA approval for the treatment of drug-resistant depression. However, the original SAINT® is still not available anywhere and awaits implementation. Meanwhile, many clinics worldwide perform a similar protocol without the use of neuronavigation with slightly worse results. Similarly, in Magwise, as the first in Poland, since 2020, we have been performing a 5-day therapy inspired by the SAINT protocol, the effect of which is dozens of satisfied patients.