MagnaCentre™ – Repetitive Transcranial Magnetic Stimulation (rTMS) Treatment for Depression

In September 2014 the MagnaCentre™, formed a partnership with the Nightingale Hospital, to deliver state of the art repetitive Transcranial Magnetic Stimulation (rTMS) treatment to patients with resistant depression. This partnership has led to the first hospital based rTMS service in the UK, and the only service in the UK to offer H-Coil ™ technology.

What is rTMS?

Repetitive Transcranial Magnetic Stimulation (rTMS) is the latest effective, non-pharmacological, treatment for depression. It has been fully licensed by the Food & Drug Administration (FDA) in the USA since 2008 and is routinely used to treat depression in many first class international hospitals (e.g. Johns Hopkins Hospital, USA). It is also increasingly used in Scandinavian and other European countries and is now covered by many international healthcare insurance companies. The basic principle of rTMS is to target short magnetic pulses over the scalp to produce electrical currents in specific brain regions that regulate mood.

Who may be suitable for rTMS?
  • Approximately 1/3rd of patients with depression do not respond to treatment. This is known as ‘treatment resistant depression’ (i.e. where antidepressants and talking therapies have failed) and can be very debilitating. In this situation, rTMS is a significant treatment option
  • Those who cannot tolerate the side effects of antidepressants, such as weight gain, sexual dysfunction and sleep problems
  • Those who do not want to have ECT
  • Women with post natal depression who wish to breastfeed and avoid transmission of anti-depressant medication
Benefits of rTMS
  • Highly effective in treating the debilitating effects of depression
  • A long lasting treatment with minimal side effects
  • Treatment is well tolerated by most people
  • Unlike ECT, does not require anaesthesia or lead to memory loss
  • Daily activities can be resumed immediately after each session
  • You can drive straight after treatment
Side effects of rTMS

rTMS is a safe procedure when the published safety guidelines are adhered to. These are comprehensively followed at the Nightingale Hospital. rTMS is extremely well tolerated by most people but can cause some minor short-term side effects including:
  • Headaches
  • Scalp discomfort at the site of stimulation
  • Tingling, spasms or twitching of facial muscles
  • Lightheadedness
  • Discomfort from noise during treatment
  • Other rare side effects include seizures (2 per 1,000 cases)
Treatment pathway and cost of rTMS

rTMS is a short but intense outpatient treatment. The treatment costs £200 per session with an average of 3-5 sessions per week for 4 to 6 weeks (20 treatment sessions in total). Each treatment session lasts around 20 minutes.

What happens in a session of rTMS?
  • You will be taken to our dedicated treatment room by your nurse or therapist and seated in a comfortable chair. Any paperwork will be completed
  • Before your first treatment begins, your nurse will need to identify ideal place to put the magnets on your head and the best dose of magnetic energy for you
  • An electromagnetic coil, which looks like a helmet, is placed over your scalp
  • The electromagnetic coil is switched on and off repeatedly to produce stimulating pulses
  • This results in a tapping or clicking sound that usually lasts for a few seconds, followed by a pause. You will also feel a tapping sensation on your forehead
  • During the course of treatment, the amount of stimulation will be changed depending on your response
  • Each treatment will last about 20 minutes and throughout you will remain awake and alert. You should allow about half an hour for your appointment
  • You should be able to resume your daily activities right after your session
What are the results of rTMS?

The rTMS service at Nightingale Hospital operates using an 'H' coil (developed following research at the National Institute of Mental Health, USA). This is the latest form of rTMS and is reported to stimulate deeper, limbic, brain regions - in addition to the limited stimulation of superficial regions targeted by earlier types of coil (e.g. the figure of 8 coil).

Remission after 5 weeks with dTMS (deep TMS

A multi-centre study of 212-patients receiving deep rTMS using the H-Coil versus ‘sham’ (placebo) treatment.

This study led to FDA approval for the H-Coil (Brainsway)

When is rTMS not suitable?
  • For those with co-morbid neurological disorders, history of epilepsy, stroke, and/or neurosurgery.
  • For those who have metal plates in the head / brain, the presence of pacemakers or other electronic implants, inner ear implants, metal or magnetic objects in the brain and medication pumps
  • For people with alcohol and / or drug dependency
  • Age below 18 years
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