Does TMS Cause Brain Damage?

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By Dr. David Woo - September 22, 2020

TMS has been gaining a lot of attention for its ability to relieve depressive symptoms for people with treatment-resistant depression, and for its potential to treat patients with other conditions like anxiety and PTSD. TMS uses magnetic pulses to stimulate the brain to relieve depressive symptoms. As with any new treatment, it’s common for misconceptions to surface and cause confusion about what effects it can have. Below are some of the most common myths about TMS.

Myth #1: It Causes Brain Cancer or Brain Damage

The FDA approved TMS in 2008 because clinical studies show that it is a safe and effective treatment for depression. There is no clinical evidence that TMS causes brain damage or brain cancer, and research shows that TMS does not cause structural brain changes. (1)

TMS uses the same type and strength of magnetic pulses as those produced by an MRI (magnetic resonance imaging) machine. MRI has been used for diagnosis since 1984 (when it was approved by the FDA) and is not associated with any short or long-term adverse effects. (2,3)

Myth #2: It Changes Your Personality

TMS does not change a person’s personality. As treatment progresses, patients may notice improvements in cognitive abilities and the ability to interact and function on a daily basis, but this is likely because their depression symptoms are lifting. Signs of improvement in depressive symptoms may include:

Increased energy
Normal appetite
Better concentration
More interest in activities
Increased libido
Fewer feelings of irritability
Feeling more at peace and less overwhelmed

A great way to monitor how TMS treatment improves depressive symptoms is to keep a diary of your moods and symptoms throughout the treatment course.

Myth #3: It’s Painful

TMS is a pain-free, outpatient treatment that’s performed without the need for anesthesia. During a TMS session, patients may feel a tapping sensation on the scalp where the magnetic pulses are directed.

The most common side effect associated with TMS is scalp discomfort and a mild headache that usually subsides within a few hours after a session. (1) But even these side effects occur infrequently. Patients who do experience them can find relief with over-the-counter pain medications, like Advil or Tylenol.

Myth #4: It Causes Memory Loss

TMS does not cause memory loss. When patients associate brain stimulation with memory loss, they are often confusing ECT (a different depression treatment) with TMS. ECT (electroconvulsive therapy) is associated with memory loss and confusion, whereas research shows that TMS may actually improve age-related memory loss in older adults. (4,5,6) Learn more about the differences between TMS and ECT.

Myth #5: It Makes Depression Worse

Numerous clinical studies prove that TMS is effective in relieving depressive symptoms. (7,8) However, a small percentage of patients may experience what is called a “dip” approximately halfway through treatment. A dip is characterized by a temporary worsening of symptoms. Patients can also experience a dip when taking antidepressants, so this is not a phenomenon that’s unique to TMS. Once the dip is over, most patients begin to see relief from their depression symptoms. Learn more about the TMS dip.

Some people who experience a dip with TMS may feel like it made their depression worse, but the dip is temporary. There is no clinical evidence that TMS makes depression worse.

Learn More About TMS

To learn if you could benefit from TMS, take our quiz. If you’d like to schedule an appointment, contact us online or call our office at 212.731.2033.

Resources:

1. Rossi S, Hallett M, Rossini PM, Pascual-Leone A; Safety of TMS Consensus Group. Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clin Neurophysiol. 2009;120(12):2008-2039. Link. Accessed August 20, 2020.

2. Prasad A. The (Amorphous) Anatomy of an Invention: The Case of Magnetic Resonance Imaging (MRI). Social Studies of Science. 2007;37(4):533-560. Link. Accessed August 20, 2020.

3. Hartwig V, Giovannetti G, Vanello N, Lombardi M, Landini L, Simi S. Biological effects and safety in magnetic resonance imaging: a review. Int J Environ Res Public Health. 2009;6(6):1778-1798. Link. Accessed August 20, 2020.

4. MacQueen G, Parkin C, Marriott M, Bégin H, Hasey G. The long-term impact of treatment with electroconvulsive therapy on discrete memory systems in patients with bipolar disorder. J Psychiatry Neurosci. 2007;32(4):241-249. Link. Accessed August 20, 2020.

5. Lisanby SH, Maddox JH, Prudic J, Devanand DP, Sackeim HA. The effects of electroconvulsive therapy on memory of autobiographical and public events. Arch Gen Psychiatry. 2000;57(6):581-590. Link. Accessed August 20, 2020.

6. Nilakantan AS, Mesulam MM, Weintraub S, Karp EL, VanHaerents S, Voss JL. Network-targeted stimulation engages neurobehavioral hallmarks of age-related memory decline. Neurology. 2019;92(20):e2349-e2354. Link. Accessed August 20, 2020.

7. Carpenter LL, Janicak PG, Aaronson ST, Boyadjis T, Brock DG, Cook IA, Dunner DL, Lanocha K, Solvason HB, Demitrack MA. Transcranial magnetic stimulation (TMS) for major depression: A multisite, naturalistic, observational study of acute treatment outcomes in clinical practice. Depression and Anxiety. 2012;29(7):587-96. Link. Accessed August 20, 2020.

8. O’Reardon JP, Solvason HB, Janicak PG, Sampson S, Isenberg KE, Nahas Z, McDonald WM, Avery D, Fitzgerald PB, Loo C, Demitrack MA, George MS, Sackeim HA. Efficacy and safety of transcranial magnetic stimulation in the acute treatment of major depression: a multisite randomized controlled trial. Biol Psychiatry. 2007;62(11):1208-1216. Link. Accessed August 20, 2020.

Dr. David Woo

Dr. David Woo is the owner and head clinical psychiatrist at Madison Avenue TMS and Therapy in New York City. Dr. Woo has been seeing patients in private practice since 2002, always with the goals of combining evidence-based medicine with psychodynamic psychotherapy and collaborating with other mental health professionals to ensure the best possible outcomes for his patients. He has been certified to administer TMS at his practice since 2017. His greatest clinical interests include helping patients suffering from depression, anxiety, and obsessive compulsive disorder.

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