TMS Therapy: A Breakthrough for Brain Health, Migraine, and Recovery
By: Brooklyn A. Bradley, BS; Medically edited by Dr. Deena Kuruvilla, MD
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Living with conditions like migraine, post-concussion symptoms, or treatment-resistant depression can be challenging. Many patients try multiple medications or therapies, often with limited relief. Transcranial Magnetic Stimulation (TMS) therapy is an innovative, non-invasive option that has gained attention for its potential to improve brain health.
What Is TMS Therapy?
TMS is a non-invasive brain stimulation treatment that uses gentle magnetic pulses to stimulate specific areas of the brain [2]. Unlike medications, which affect the whole body, TMS directly targets brain activity. The magnetic field is used to penetrate the scalp and skull, while the electric field creates secondary currents leading to the activation of neurons in the brain [2].
The FDA has cleared TMS therapy for:
- Major Depressive Disorder (MDD), especially for patients who have not responded to medications (treatment-resistant depression)
- Migraine with aura
- Obsessive-Compulsive Disorder (OCD)
- Anxious depression (a subset of MDD with high anxiety)
- Smoking cessation
Ongoing research is exploring TMS for concussion recovery, PTSD, chronic pain, and other neurological conditions.
How Does TMS Work?
The brain communicates through electrical signals. When certain regions are underactive or out of balance, symptoms like headaches, depression, or difficulty concentrating can appear.
- During a TMS session, a device is placed on the scalp.
- It delivers focused magnetic pulses that encourage brain cells to reconnect and “re-fire.”
- Over time, this can help restore balance in brain activity and improve symptoms.
Most patients describe the sensation as a light tapping on the head. Sessions are performed in-office, do not require anesthesia, and typically allow patients to return to normal activities immediately.
TMS for Treatment-Resistant Depression
TMS is most widely recognized for treatment-resistant depression—cases where patients haven’t found relief from multiple medications. By stimulating underactive regions of the brain involved in mood regulation, TMS can help improve symptoms of depression and support a better quality of life. Repeatedly administered TMS to the dorsolateral prefrontal cortex is an established treatment for some forms of treatment-resistant major depressive disorder [2]. TMS typically delivers stimulation in daily sessions, 5 sessions per week over a period of 2 to 6 weeks.
TMS for Migraine
Migraine can be disabling, causing intense pain, nausea, and sensitivity to light or sound. TMS offers a drug-free treatment option for patients with migraine with aura. Research shows that stimulating specific brain pathways can reduce the frequency and intensity of attacks, providing relief when medications alone are insufficient. A past study showed that single-pulse transcranial magnetic stimulation (sTMS) can provide rapid relief for migraine with aura, with 39% of patients pain-free within 2 hours compared to 22% with sham treatment [3]. The therapy is non-invasive, well-tolerated, and may offer sustained relief for 24–48 hours after a migraine attack.
TMS for Concussion Recovery
Some studies suggest TMS may help with post-concussion symptoms, such as headaches, brain fog, or difficulty concentrating. By targeting neural networks involved in recovery, TMS may support the brain’s natural healing processes. While this application is still under investigation, early findings are promising. A 2021 systematic review investigating the use of TMS for concussion discussed how repetitive transcranial magnetic stimulation (rTMS) shows promising early results for treating post-concussive symptoms, including depression and headaches, in patients with mild traumatic brain injury or concussion [4]. While the studies to date are small, rTMS is non-invasive and may offer a novel approach for symptoms that are otherwise difficult to manage.
Benefits of TMS
- Non-invasive & drug-free – no systemic side effects
- Targeted stimulation – focuses on specific areas of the brain
- Well-researched – backed by clinical studies and FDA clearance for certain conditions
- Convenient – sessions typically last 20–30 minutes with minimal disruption to daily life
Side Effects and Contraindications
It is important to consider potential side effects of TMS therapy and the populations in which TMS is contraindicated. Although TMS is considered non-invasive, and its side effect profile is rare, there is a possibility that rTMS may induce seizures. Thus, TMS is not recommended for individuals with epilepsy. Pre-existing neurological disease, adolescents, change in medication regime, and active substance use should also be taken into account, as these factors may lower the seizure threshold [5]. In addition, metallic/electronic implants or cochlear implants that are in close contact with the TMS coil are also a contraindication.
TMS is generally well-tolerable; however, there may be the presence of post-treatment headaches, neck pain, or toothache. Muscle twitching may also occur during treatment.
Key Takeaways
TMS therapy represents a growing field in brain health and neurological care, with FDA-approved applications for depression, migraine, OCD, and smoking cessation. While not every patient is a candidate, it provides an alternative or complementary approach for those who have not found relief with conventional treatments.
References:
- Photo by Google DeepMind: https://www.pexels.com/photo/an-artist-s-illustration-of-artificial-intelligence-ai-this-image-represents-how-machine-learning-is-inspired-by-neuroscience-and-the-human-brain-it-was-created-by-novoto-studio-as-par-17483869/
- Eldaief MC, Press DZ, Pascual-Leone A. Transcranial magnetic stimulation in neurology. Neurol Clin Pract. 2013;3(6):519-526. doi:10.1212/01.CPJ.0000436213.11132.8e
- Lipton RB, Dodick DW, Silberstein SD, et al. Single-pulse transcranial magnetic stimulation for acute treatment of migraine with aura: a randomised, double-blind, parallel-group, sham-controlled trial. Lancet Neurol. 2010;9(4):373-380. doi:10.1016/S1474-4422(10)70054-5
- Mollica A, Safavifar F, Fralick M, Giacobbe P, Lipsman N, Burke MJ. Transcranial magnetic stimulation for the treatment of concussion: a systematic review. Neuromodulation. 2021;24(5):803-812. doi:10.1111/ner.13319
- Taylor R, Galvez V, Loo C (2018) Transcranial magnetic stimulation (TMS) safety: a practical guide for psychiatrists. Australas Psychiatry 26:189–192. https://doi.org/10.1177/1039856217748249