Transcranial magnetic stimulation (TMS) means stimulating, non-invasively, the areas of the brain closely involved in emotion and mood control.
1. View
A 3D view of your brain is examined using MRI scan (treatment is safe & FDA cleared).
2. Measure
Therapy is personalized to your brain state. (SmartFocus® TMS treatment can be personalized to everyone).
3. Target
The area of your brain that needs the therapy is pinpointed, using SmartFocus® TMS navigation.
4. Treat
With precision we are able to treat the area of your brain closely involved in depression.
5. Repeat
Vital treatment data is saved and ready for the next treatment session. (# of sessions needed may vary)
1. View
A 3D view of your brain is examined using MRI scan (treatment is safe & FDA cleared).
2. Measure
Therapy is personalized to your brain state. (SmartFocus® TMS treatment can be personalized to everyone).
3. Target
The area of your brain that needs the therapy is pinpointed, using SmartFocus® TMS navigation.
4. Treat
With precision we are able to treat the area of your brain closely involved in depression.
5. Repeat
Vital treatment data is saved and ready for the next treatment session. (# of sessions needed may vary)
*O’Reardon et al., Efficacy and safety of transcranial magnetic stimulation in the acute treatment of major depression: a multisite randomized controlled trial. Biol Psychiatry 2007 Dec 1; 62(11): 1208-1216. Epub 2007 Jun 14. PubMed PMID: 17573044.
*Lisanby et al., Daily left prefrontal repetitive transcranial magnetic stimulation in the acute treatment of major depression: clinical predictors of outcome in a multisite, randomized controlled clinical trial. Neuropsychopharmacology. 2009 Jan; 34(2):522-34. Epub 2008 Aug 13. PubMed PMID: 18704101.
*Carpenter L. et al. Transcranial Magnetic Stimulation (TMS) for Major Depression: A Multisite, Naturalistic, Observational Study of Acute Treatment Outcomes in Clinical Practice. Depress Anxiety, 29 (7), 587-96 Jul 2012
Did you know…? Not all TMS treatments are the same.
Why would you want to go anywhere else for TMS treatment?
TMS treatment works by targeting the stimulation to the region of your brain involved in depression.
Without the right technology, it’s like looking for something blindfolded.
Unique SmartFocus® navigation allows for pinpoint accuracy which has been clinically validated in neurosurgery. No other TMS technology has the same technological capabilities.
Did you know…, not all TMS treatment is created equal.
Why would you want to go anywhere else for TMS treatment?
TMS treatment works by targeting the stimulation to the region of your brain involved in depression.
Without the right technology, it’s like looking for something blindfolded.
Unique SmartFocus® navigation allows for pinpoint accuracy which has been clinically validated in neurosurgery. No other TMS technology has the same technological capabilities.
FDA: Nexstim Navigated Brain Therapy (NBT) System 2 is indicated for the treatment of Major Depressive Disorder in adult patients who have failed to achieve satisfactory improvement from prior antidepressant medication in the current episode. Nexstim NBT System 2 is intended to be used by trained clinical professionals.
NBT THERAPY SHOULD NOT BE GIVEN TO
Patients with non-removable conductive, ferromagnetic, or other magnetic-sensitive metal anywhere in the head or within 30 cm (12 in) of the stimulation coil. Examples include cochlear implants, implanted electrodes or stimulators, aneurysm clips or coils, stents, bullet fragments, ocular implants, and stents.
Patients who have an active or inactive implanted device (including device leads), including deep brain stimulators, cochlear implants, cardiac pacemakers, and vagus nerve stimulators. Contraindicated use could result in serious injury or death.
Patients with increased intracranial pressure or patients with intracardiac lines, intravenous pumps, or dose calculators.
Failure to follow these restrictions could result in serious injury or death.
RISKS AND SIDE EFFECTS
Seizures (convulsions): Cortical magnetic stimulation runs the risk of inducing seizures; although they are rare. Under ordinary clinical use, the estimated risk of seizure is approximately 1 in 30 000 treatments (0.003%) or 1 in 1000 patients (0.1%).
Headache: The most common side effects reported during clinical trials are mild headache (~50% of TMS treatment group) and scalp pain or discomfort (35.8%). In general, headache and pain on the stimulation site have been generally mild to moderate and occurring less frequently after the first week of treatment. The reason for headache may be the tension of scalp and neck muscles due to an uncomfortable and stressful situation.
Muscle Twitching: You may feel twitches in the muscles of your arm, leg or face during the magnetic stimulation. This is a common sensation but not hazardous. The twitches will stop when the magnetic stimulation stops.
Skin Irritation: There is a small risk of mild skin irritation at the location where the muscle electrode sensors have been placed, but this usually consists of minor redness that will go away quickly after they are removed.
Changes in hearing: The loud “click” produced by the TMS stimulator can cause temporary hearing changes following treatment. This is prevented by wearing soft foam ear plugs during treatment. No problems with hearing due to TMS have ever occurred when earplugs have been properly worn
INEFFECTIVE TREATMENT
There is no evidence that single therapy sessions would improve mood. rTMS treatment effects in reducing depression are temporary, and patients may need to continue other forms of depression therapy. Relapse into depression is likely without follow-up treatment. Notify your doctor in case of worsening depression or suicidality.
CAUTION: SPECIAL POPULATIONS
All patients must be screened for the characteristics listed in this section and excluded without clear benefit or compelling clinical reason.
The safety and effectiveness of Nexstim TMS treatment has not been established in the following patient populations:
Younger than 22 years or older than 70 years
Suicide plan or recent suicide attempt
History of concurrent use of electroconvulsive therapy (ECT) or vagus nerve stimulation (VNS)
Depression secondary to a general medical condition or substance-induced
Seasonal affective disorder
History of substance abuse, obsessive compulsive disorder, or post-traumatic stress disorder
A psychotic disorder, including schizoaffective disorder, bipolar disorder, or major depression with psychotic features
History of increased intracranial pressure or head trauma
The clinical efficacy and safety of 10 Hz rTMS stimulation of the left dorsolateral prefrontal cortex in the treatment of MDD has been studied in a sham-controlled multicenter clinical trial (see O’Reardon et al.*) with an overall population of 301 patients meeting DSM-IV criteria in the diagnosis of MDD. MDD episode as defined by DSM-IV involves the nearly daily presence during the same two-week period of five or more of the following symptoms:
Depressed mood most of the day as indicated by either subjective report or observation made by others
Markedly diminished interest or pleasure in all, or almost all, activities most of the day
Significant weight loss or weight gain, or decrease or increase in appetite
Insomnia or hypersomnia
Psychomotor agitation or retardation
Fatigue or loss of energy
Feelings of worthlessness or excessive or inappropriate guilt
Diminished ability to think or concentrate, or indecisiveness
Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
Figure: Change from baseline in MADRS score during active or sham rTMS treatment in patient population with one adequate antidepressant treatment (modified from Reference 10.)
Efficacy of the treatment was established in retrospective analysis (see Lisanby et al.**) for the outpatient group (164 patients, aged 18-70 years) who had one adequate antidepressant treatment in the current episode but failed to achieve satisfactory improvement and were moderately to severely symptomatic. Efficacy of treatment, sham or active stimulation, was measured in total change in MADRS score at 2, 4 and 6 weeks into treatment when compared to baseline level (see the figure).
*O’Reardon et al., Efficacy and safety of transcranial magnetic stimulation in the acute treatment of major depression: a multisite randomized controlled trial. Biol Psychiatry 2007 Dec 1; 62(11): 1208-1216. Epub 2007 Jun 14. PubMed PMID: 17573044.
**Lisanby et al., Daily left prefrontal repetitive transcranial magnetic stimulation in the acute treatment of major depression: clinical predictors of outcome in a multisite, randomized controlled clinical trial. Neuropsychopharmacology. 2009 Jan; 34(2):522-34. Epub 2008 Aug 13. PubMed PMID: 18704101.
Are you a physician interested in offering your patients SmartFocus® TMS treatments? Visit our physician information page for more information and contact us at info@nexstim.com.
It’s time to smile again.
Freedom from depression is worth fighting for. Our goal is to help you break free from depression with a safe, non-drug treatment.
In the United States most major commercial payers reimburse TMS treatment for depression and there is a 100% Medicare coverage for TMS. There are CPT codes available for both therapeutic repetitive TMS treatment and subsequent delivery and management per session. Ask your doctor whether SmartFocus® TMS may be the right option for you.
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