Island Psychiatry is the first practice in the United States to offer
Neuronavigated TMS with
Nexstim SmartFocus Technology
Transcranial magnetic stimulation (TMS) is a noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. TMS is typically used when other depression treatments haven't been effective but can be used first if the patient wants to avoid medications (for a variety of reasons) and if the physician approves.
There are promising results for other uses of TMS therapy in patients with ADHD, OCD, autism, tinnitus, neuropathic pain and other neuropsychiatric conditions. Trials are in progress for stroke rehabilitation and smoking cessation. While clinical studies are in progress and TMS is seen as experimental in some cases, we are also looking at our own data to help us determine which protocols are most effective for our patients.
1985
TMS was Introduced
70%
Partial and full responders
6
Qualified
TMS Professionals
at Island Psychiatry
2008
FDA Approval for
Treatment of Depression
Compare Standard and Neuronavigated TMS
Neuronavigated TMS
Nexstim Smart Focused TMS
Unlike Standard TMS, Neuronavigated TMS is precisely mapped and focused in real time using an MRI of the patient's brain which is uploaded into the device. This takes the guesswork out of locating the exact areas of the brain (such as the DLPFC for depression) which need to be stimulated in order to achieve the desired therapeutic effect. Neuronavigated TMS uses the same electromagnetic coil as standard TMS to enhance or inhibit activity in the brain but it does so far more precisely. This may lead to better efficacy and allows us to target areas for "off label" use such as tinnitus, OCD, chronic pain, PTSD, Parkinson's and other disorders.
Setting:
Conducted most often in a TMS specialised out patient practice.
Duration:
Treatment time can vary from 5-30 minutes
Frequency:
Daily treatments (3-5 times per week) for an average of 6 weeks (36 sessions).
Risks and side effects:
A multitude of clinical studies have proven that TMS and dTMS are extremely well tolerated with few if any side effects. A few patients may experience temporary side effects including headache, discomfort on scalp, dizziness and lightheadedness. Some people report tingling on the scalp during the session.
Transcranial Magnetic Stimulation
Standard TMS
Just like navigated TMS, standard TMS modulates the brain's "neural networks" (collections of nerve fibers) using magnetic fields. This magnetic energy passes through the skull to target a mood regulating area of the brain in the frontal area called the Dorsal Lateral Prefrontal Cortex (DLPFC). The DLPFC location is found using specific measurements of the scalp. The actual brain is never visualized. Targeting other areas of the brain is even more difficult because there are no algorithms for measurement as there is for the DLPFC. There is nothing inferior about the actual stimulation administered by the standard device. Island psychiatry has both navigated and standard TMS machines.
Setting:
Conducted most often in a TMS specialized out patient practice.
Duration:
Treatment time can vary from 5-30 minutes
Frequency:
Daily treatments (3-5 times per week) for an average of 6 weeks (36 sessions).
Risks and side effects:
A multitude of clinical studies have proven that TMS and dTMS are extremely well tolerated with few if any side effects. A few patients may experience temporary side effects including headache, discomfort on scalp, dizziness and lightheadedness. Some people report tingling on the scalp during the session.