We are now expanding our service to include “Off Label” applications for TMS and also offering another form of TMS called Theta Burst Stimulation (TBS) and a specialised TMS service for clients with OCD (Obsessive Compulsive Disorder).

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TBS “Off Label” protocols can be achieved with shorter treatment times by using a stimulation type referred to as theta bursts. TBS ‘bursts’ can result in fewer treatment days – substantially lowering costs allowing us to provide the best possible price for our patients.

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Such sessions will also allow therapy interventions to be conducted in conjunction with TBS sessions. Therapy interventions such as Cognitive Behavioural Therapy, Eye Movement Desensitisation Reprocessing and Dialectic Behaviour Therapy will now be able to be conducted with patients on the same day and within an approximate 1-hour timeframe during which a client can have two Theta Burst Stimulation TMS sessions and a therapy session. This would be recommended 2-3 times in the week. 

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 Such an approach in Europe and the United States where TMS is combined with therapy interventions has shown a significant improvement in response rates to treatment for mental health conditions.

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Neuro Health Solutions is offering a specialised service for obsessive compulsive disorder (OCD). We have now added a specialised coil that allows TMS to occur for deeper structures that are integral to treatment for obsessive compulsive disorder. We use MagVenture machines and coils as MagVenture was the first TMS machine developer to gain FDA approval for equipped device as an indicated treatment option for major depression and also, the Coil Cool DB-80 (OCD Coil) as an approved FDA treatment option for obsessive compulsive disorder (OCD). 

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What is “Off Label” TMS Therapy?

The FDA has only cleared TMS Therapy for Major Depression, despite overwhelming scientific evidence that TMS Therapy is being successfully used to treat a wide range of other mental disorders and illnesses globally. When TMS therapy is administered for treatment of other mental disorders, not currently cleared by the FDA it is described as “off label”.

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What other illnesses have been successfully been treated by “Off Label” TMS?

Leading Clinics and hospitals globally are using TMS to successfully treat:

• ADD/ADHD

• Chronic Pain Neuropathic pain control

• Anxiety Disorder

• PTSD

• Obsessive Compulsive Disorder

• Substance Abuse/Addictions to alcohol, drugs, and nicotine

• Panic Disorder

 

Why is Theta Burst Stimulation (TBS) ideal for “Off Label” applications?

TBS is backed by scientific research and is being used extensively in Europe, USA and by the nation health service in Canada. It can be administered in a fraction of the treatment time (3-6 minutes vs 20-36 minutes for FDA cleared standard in the U.S currently providing equal or better results.

  

TBS “Off Label” protocols can be achieved with shorter treatment times by using a stimulation type referred to as theta bursts. TBS ‘bursts’ can result in fewer treatment days – substantially lowering costs allowing us to provide the best possible price for our patients.
 

We currently have Theta Burst Sessions

Theta Burst TMS, also known as TBS, employs a new way of applying TMS trusted, effective, non-invasive, and non-convulsive brain stimulation. In August of 2018, MagVenture was the first TMS machine developer to gain FDA approval for a Theta Burst equipped device as an indicated treatment option for major depression. MagVenture has deemed TBS ‘Express TMS’, and with good reason – TBS sessions are about 10 times faster than traditional TMS treatments. Neurotherapy TMS’ new, TBS treatment option allows us to customise patients’ treatment plans, including as a long-term maintenance TMS treatment option.

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How Theta Burst TMS Works

While traditional TMS employs 10 Hz magnetic frequency for 20-40 mins, TBS uses 50 Hz magnetic frequency for just three minutes. TBS sends rapid bursts, mimicking the brains neuronal pattern of firing theta waves. Theta brain waves are considered the keys to learning, memory, and intuition. They cause the mind to focus on signals from the external world, rather than on its sensory details. Theta brainwaves are primarily experienced in sleep; however, they can also be achieved through meditation. Some find themselves in a theta brain state while performing tasks such as showering or freeway driving periods where many people feel they get their best ideas.

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Theta Burst TMS backed by Largest Trial to Date

 The largest double-blinded, randomised TBS trial to date was published in 2018. Patients between the ages of 18-65 from three separate Canadian university hospitals were used to compare the effectiveness and patient experience with TBS and traditional TMS.

The study spanned three years. It divided its 414 patients into two randomised groups, treating 205 patients with standard, 10 Hz TMS and 205 patients with 50 Hz TBS.

The results revealed the effectiveness of both methodologies. The researchers used the Hamilton Rating Scale for Depression (HRSD-17) to analyse the patient’s treatment outcomes. The group treated with standard TMS improved their HRSD-17 scores from 23.5 to 13.4 and the TBS patients improved their scores from 23.6 to 13.4.

 

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The TMS Process​

Step 1: Initial Screening
– Initial screening happens once the patient is referred to us or contacts us to seek treatment.
There will be an initial phone call to review the referral, for those seeking treatment this would be the initial call.
– Lastly, during this step our front-desk reception will schedule an intake appointment.

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Step 2: Clinical Consult
Clinical consult appointments is approximately a 1-hour appointment with Glen Davey.

During this appointment Glen will:
– Review the patient’s medical history with the patient
– Check to see if the patient meets criteria for TMS therapy
– Analyse if TMS therapy is the right therapy for the patient
– Lastly, he will discuss the logistics and parameters of treatment, and determine how the treatment schedule will look like with the patient.

-Other therapeutic interventions such as CBT, EMDR and DBT will be offered in conjunction with TMS treatments, Research conducted with TMS in combination with therapy intervention shows a significant   improvement in success rate for patients. 

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Step 3: Prior Assessment  
Relevant clinical assessments such as the PAI, DASS, Beck Depression Inventory, PTSD Checklist, Addiction Scale. Possible YBOCS, Pain Scale, Tova and QEEG assessment would be conducted before a client starts treatment. These will be repeated at the three week and six-week mark of a program or conversely in the middle and end of treatment.

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Step 4: Motor Threshold
This is performed on the first appointment of TMS treatment, before the first treatment is administered. The motor-threshold will be re-determined a couple times throughout the treatment course to ensure accuracy of the treatment, this varies from patient to patient. Essentially, the motor threshold determines the amplitude, or the dosage, of the treatment.

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Step 5: TMS Acute Treatment Session
On the first day of treatment, patients will undergo the motor threshold procedure, and measurement of target spot with a personal individual cap before beginning their first treatment. With the motor threshold included, the first day of treatment will take up to an hour with trims and 30 minutes with Theta Burst.

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Step 6: TMS Continuous Treatment Sessions
Each visit following the first day of treatment will typically last 30-45 minutes with rTMS, and 10-15 minutes with Theta Burst program, this of course depends on the patient and may have a variance. For the most part, TMS technicians can work around a patient schedule to determine a consistent time of treatment Monday through Friday.

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Step 7: After Care
After receiving rTMS initially few weeks after the completion of treatment, Glen Davey and a TMS Technician will follow up and check in to see how patients are feeling. At this point in care, it will be determined if maintenance treatments are needed for the patient, depending on their case.