Repetitive transcranial magnetic stimulation (rTMS)

rTMS is the abbre­via­ti­on for “repe­ti­ti­ve tran­s­cra­ni­al magne­tic sti­mu­la­ti­on”, a form of non-inva­si­ve neu­ro­sti­mu­la­ti­on that has now been very well rese­ar­ched sci­en­ti­fi­cal­ly. This invol­ves app­ly­ing a rapidly oscil­la­ting magne­tic field with a spe­cial magne­tic coil over cer­tain are­as of the brain to influence the acti­vi­ty of cer­tain under­ly­ing brain are­as. The pro­ce­du­re is now wide­ly used to impro­ve brain func­tion in num­e­rous neu­ro­psych­ia­tric dis­or­ders as well as in healt­hy indi­vi­du­als for tar­ge­ted per­for­mance enhance­ment.

The appli­ca­ti­on of rTMS increa­ses or decrea­ses the acti­vi­ty of cer­tain cells and brain are­as loca­ted under the sti­mu­la­ti­on site by up to 20–40% depen­ding on the appli­ed fre­quen­cy, which can cau­se an effec­ti­ve per­ma­nent chan­ge in brain acti­vi­ty. rTMS can signi­fi­cant­ly impro­ve mood and emo­tio­nal sta­te, cogni­ti­ve abili­ties, memo­ry, social skills and neu­ro­nal sta­bi­li­ty over lon­ger peri­ods of time, depen­ding on the spe­ci­fic brain regi­ons sti­mu­la­ted or modu­la­ted depen­ding on the sym­ptoms.

Num­e­rous sci­en­ti­fic stu­dies have shown that with appro­pria­te tar­ge­ted use over a peri­od of seve­ral weeks, mood, lan­guage and mathe­ma­ti­cal skills, atten­ti­on span, pro­blem-sol­ving abili­ty, coor­di­na­ti­on and memo­ry per­for­mance as well as many other neu­ro­psy­cho­lo­gi­cal skills can be signi­fi­cant­ly impro­ved. The­se func­tion­al impro­ve­ments can be used alo­ne or in com­bi­na­ti­on with other the­ra­peu­tic pro­ce­du­res to acce­le­ra­te the heal­ing pro­cess. rTMS is now suc­cessful­ly used as an alter­na­ti­ve or sup­ple­ment to other pro­ce­du­res for many dise­a­ses.

Ner­ve cells are elec­tri­cal­ly char­ged, so the func­tion of the brain is based on elec­tri­cal curr­ents in addi­ti­on to the well-known effect of mes­sen­ger sub­s­tances. In most neu­ro­psych­ia­tric dis­or­ders, the­re is a dis­tur­ban­ce in the acti­vi­ty or regu­la­ti­on of brain tis­sue. By app­ly­ing rapidly swit­ched strong magne­tic pul­ses using a spe­cial magne­tic coil, the brain tis­sue is exci­ted or down-regu­la­ted depen­ding on the set fre­quen­cy, uti­li­zing the prin­ci­ple of induc­tion. This means that its acti­vi­ty can be spe­ci­fi­cal­ly influen­ced.

The­re are now a num­ber of sci­en­ti­fic stu­dies under sophisti­ca­ted con­trol con­di­ti­ons. The effec­ti­ve­ness of rTMS is about as good as that of sui­ta­ble medi­ca­ti­on. The pro­ce­du­re is often supe­ri­or to drug the­ra­py, as num­e­rous stu­dies have shown in cases of tre­at­ment-resistant cour­ses with purely drug the­ra­py. In prac­ti­ce, the indi­vi­du­al com­bi­na­ti­on of rTMS with other approa­ches, in par­ti­cu­lar with psy­cho­the­ra­peu­tic tre­at­ment, has pro­ven suc­cessful in achie­ving a las­ting impro­ve­ment in health rest­ric­tions and a healt­hy sta­te.

The pro­cess of magne­tic sti­mu­la­ti­on using rTMS also alters the acti­vi­ties of various neu­ro­trans­mit­ters in the brain (inclu­ding sero­to­nin, nor­ad­re­na­line, dopa­mi­ne, glut­ama­te and others). Repea­ted appli­ca­ti­on of the pro­ce­du­re can achie­ve las­ting chan­ges, regu­la­te over­ac­ti­ve regi­ons of the brain and acti­va­te underac­ti­ve regi­ons. When used in a tar­ge­ted man­ner, this can nor­ma­li­ze brain acti­vi­ty and thus also tre­at many neu­ro­psych­ia­tric dis­or­ders.

This is an indi­vi­du­al health ser­vice (so-cal­led IGeL) or “self-pay­er ser­vice”, which is not cover­ed by sta­tu­to­ry health insu­rance. With pri­va­te health insu­rance com­pa­nies, a cost appli­ca­ti­on can be sub­mit­ted, which is deci­ded on indi­vi­du­al­ly by the insurer.

Cos­ts for rTMS 100 euros per ses­si­on. For effec­ti­ve the­ra­py, 20 ses­si­ons are requi­red in the first month, fol­lo­wed by 10 main­ten­an­ce ses­si­ons with weekly appli­ca­ti­on.