Clinical Applications of TMS

The most common form of depression shows a typical activity pattern in the brain: neurons in the left prefrontal cortex are inhibited while neurons in the right prefrontal cortex are overactive. Certain TMS applications activate left prefrontal areas. A TMS treatment is particularly suited when medical treatments have been without success or are not an option and electroconvulsive therapy is not yet feasible. TMS can also be applied in combination with traditional treatment methods.

A high neural activity supports the healing process after a stroke. Unfortunately, the damaged area is often subjected to suppressing signals from the healthy cerebral hemisphere which is hyperactive due to compensation. TMS procedures usually indirectly support the neural functionality in the affected area by either inhibiting the overactive hemisphere or by directly stimulating both hemispheres, synchronously activating the affected hemisphere.

A hypofunction of the left dorsolateral prefrontal cortex is typical for this disease. Stimulating this part of the brain with TMS couteracts the hypofunction and supports treatment. Additionally in case of auditory hallucinations, affected auditory regions in the temporoparietal cortex are hyperactive and can be suppressed with TMS.

Suppressing activity of the right dorsolateral prefrontal cortex with TMS can be efficacious towards mitigating panic disorders. TMS procedures that activate prefrontal areas focally or extensively can also be applied for treating posttraumatic stress disorders.

Neuropathic pain such as trigeminal or phantom limb pain originates within the nervous system itself. Usually, this type of pain is treated by actively stimulating the motor cortex. Pain relief often occurs after the first TMS treatment and can last for several weeks.

The disturbing sounds usually originate from a compensatory hyperactivity of parts of the cortex. A TMS treatment can control the over-excitation of the auditory cortex and thus stop or at least mitigate the noise.

Migraines cyclically lower the quality of life. TMS therapy is split up into acute pain treatment and prophylaxis. Both approaches show effects. The treatment of acute migraine attacks is recommended for patients with aura, while the prophylactic method shows success in both patient groups.