TMS: Know your options!
Which transcranial magnetic stimulation (TMS) modality is right for you?
There are two kinds of TMS: 1)with a figure of 8 coil (e.g. Neurostar, MagVita, Magventure, and more.) and 2)an H1 coil (Brainsway). In Milwaukee, Wisconsin, we are the only practice offering deep TMS. Both modalities are effective for depression. However, in large multisite studies that a control group AND blinding, remission is only about 15% with a figure of 8 coil. Remission is more than double using deep TMS. The cost for the patient is the same and almost all insurances are now covering TMS. When finding a high quality provider, it is important to have both a physician and technicians who are experienced at TMS to ensure you get effectively delivered treatment.
A high quality practice also has a physician on site, and readily available for follow up, concerns, and questions. Just like any medical procedure, success of treatment also depends on how well carried that procedure is. Particularly with figure of 8 coils, targeting and accuracy of treatment is essential given the shallow depth of penetration and small area of brain tissue that is stimulated. Contact with the coil needs to be secure as magnetic fields decay quickly per mm of distance between coil and scalp. Rates of remission can also vary greatly between practices depending of the level of expertise of both the physician and technician. Stanford utilizes deep TMS with a remission rate exceeding 60%. As of today, our remission rate is 66%.