TMS (transcranial magnetic stimulation)
Mental Health · Non-invasive neuromodulation
Tier A-
What this is
Standard protocol has been eclipsed by accelerated/theta-burst variants in many clinics. SAINT (Stanford Cole 2020) demonstrated remission in ~80% of TRD patients with 5-day protocol; Magnus Medical's SAINT Neuromodulation System received FDA clearance in 2022. Expensive and time-intensive but often covered. Durability issue — relapse within months in many patients without maintenance.
Mechanism
Pulsed magnetic fields induce focal cortical currents; repetitive TMS (rTMS) over left DLPFC is the standard MDD protocol; Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT) delivers a week's worth of sessions in days; deep TMS and theta-burst variants expanding
Dose & route
Standard: 5x/week x 4-6 weeks; SAINT: ~50 sessions in 5 days
Citations
- https://pubmed.ncbi.nlm.nih.gov/33028872/
- https://pubmed.ncbi.nlm.nih.gov/31846944/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC9076714/
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