What is TMS?

Transcranial magnetic stimulation (TMS) is a safe therapeutic method based on a magnetic field and the phenomenon of electromagnetic induction for precise neuromodulation of the brain's bioelectric activity. It is an alternative method of treating some mental disorders, especially drug-resistant ones. TMS therapy has been officially approved for use by many serious institutions, including the American Food and Drug Administration (FDA) and the British National Institute for Health and Care Excellence (NICE), which are well known for strict regulations. TMS therapy is widely available and recommended in many countries where it is additionally reimbursed (USA, UK, Netherlands).

TMS Stimulation

TMS GUIDE

TMS - how does it work?

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.

TMS Guide

Treatment protocols

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.

TMS Guide

The SAINT protocol and its history

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.

How to start treatment?

TMS therapy is carried out under the supervision of a physician - a specialist psychiatrist. Not every condition can be treated with TMS. To start treatment, you must first make an appointment for a qualifying consultation.

Get in touch

Send an email to: stymulacja@magwise.pl or call +48 662 277 477 or send the

Qualifying consultation

In the office or remotely (Skype), during which a specialist psychiatrist will assess the chances of success of the therapy and propose the most favorable stimulation protocol

Setting dates

Arrange the stimulation schedule with the assistant

Sample therapy

Standard TMS protocol

The best proven, FDA approved for the treatment of drug-resistant depression. Sessions are performed once a day and last about 20 minutes. The therapy lasts 30 working days.

Duration: 30 days
Number of sessions: 1 session a day
Duration of the session: 20 minutes
Effectiveness: About 50%

SAINT-TRD protocol

It is an intensive accelerated iTBS inspired by Stanford Accelerated Intelligent Neuromodulation Therapy protocol (SAINT-TRD, SNT). Ten several minutes of iTBS sessions a day, performed every hour. It is probably the most effective antidepressant therapy existing - 80% of patients go into remission. For comparison - only about 33% of patients undergo remission within the first 12 weeks of treatment with antidepressants.

Duration: 5 days
Number of sessions: 10 sessions a day
Duration of the session: 10 minutes
Effectiveness: about 70%

Find out what we can offer you

INDICATIONS

How can we help you?

The range of conditions we can treat with TMS is extensive.

Depression

drug-resistant depression (TRD)
depressed people whose medications give little improvement or have unbearable side effects
depression in the course of bipolar disorder (bipolar disorder)
depression in pregnancy and postpartum depression

OCD spectrum

obsessive-compulsive disorder (obsessive-compulsive syndrome)
tics
Tourette's syndrome
hypochondriac disorders, dysmorphophobia
depersonalization-derealization syndrome (DPD)
disorders of habits and drives (behavioral addictions) such as - gambling, workaholism, shopaholism, trichotillomania computer / internet / telephone addiction porn addiction

Other

borderline personality disorder (BPD)

Anxiety disorders

generalized anxiety disorder (GAD)
anxiety-depressive syndrome, depressive neurosis
post-traumatic stress disorder (PTSD)
Insomnia

Addictions

alcohol/nicotine addiction
addiction to stimulants (cocaine, amphetamines)
behavioral addictions: shopaholism, workaholism, pathological gambling, trichotillomania, addiction to computers, telephone, pornography

Cognitive functions

dementia, including Alzheimer's disease
brain fog (mental fatigue, covid fog)
improvement of cognitive functions in healthy people - the so-called neuroenhancement

High statistics of performance

Collected results of treatment with TMS therapy of patients in Magwise clinics

Patients undergoing TMS therapy

Of patients who felt improvement

Frequently Asked Questions

Can't find the answer to your question? Contact us.

WHO IS NOT Suitable FOR TREATMENT?

The only absolute contraindication to TMS is the presence of ferromagnetic materials in the head, such as, for example, cochlear implants or vascular clips. But, attention! This does not apply to dental materials that do not impede the use of TMS.

For safety reasons, TMS is not recommended for people:

after brain injuries, strokes, neurosurgical operations with epilepsy (only for high frequencies)
with current psychotic symptoms (hallucinations, delusions)
having implanted devices - the so-called implants, such as a cochlear implant, pacemaker, or insulin pump
with other metal elements in the body, such as vascular stents, metal clips, fragments, bullets

IS TMS PAINFUL?

At high frequencies (50 Hz, 10 Hz) during the session, the patient feels a kind of teasing/nibbling on the stimulated area - especially at the beginning of the session, but this is "bearable." After a few minutes, the so-called habituation follows, i.e., getting used to the stimulus, and the pain sensations almost disappear. We never had to interrupt the procedure because of the pain. Conventional painkillers such as paracetamol or ibuprofen taken 30 minutes before the session improve patient comfort. In the case of low frequencies (1 Hz), there are no pain sensations in the treatment protocol for obsessive-compulsive disorder. Instead, patients report exceptional pleasure and a feeling of "relief" during the session.

DO I NEED A REFERENCE FROM MY DOCTOR?

No referral is needed. However, you should have an interview with a psychiatrist (in person at the office or online).

Dr. Piotr Sulik and Dr. Tomasz Kowalczyk are qualified for the treatments. If there is any, medical records should be prepared for inspection - especially records from psychiatric hospitals and the results of brain imaging tests (CT, MRI, EEG).

HOW MANY SESSIONS DO I NEED TO FEEL POSITIVE?

Most often, improvement occurs after 12-15 sessions. However, some patients feel better between the 20th - 30th session. The optimal number of sessions in a therapeutic cycle is 30 sessions.