What’s the Difference between dTMS and rTMS?

rTMS is the Predecessor of dTMS

In short, rTMS or “repetitive transcranial magnetic stimulation” is the predecessor of dTMS (“deep  transcranial magnetic stimulation”). rTMS uses a figure-eight coil to create a magnetic field within the brain which penetrates up to 1.5 cm. rTMS is called “repetitive” because it sends more than one pulse to the brain during a single treatment. This treatment has been deemed effective in the treatment of major depressive disorder. A single treatment of rTMS takes 40 minutes and treatments must be administered every day for four to six weeks.

dTMS was approved by the FDA as a treatment for major depressive disorder in 2008. It’s a more advanced approach to transcranial magnetic stimulation. Instead of the figure-eight coil used in repetitive transcranial magnetic stimulation, dTMS uses an H-coil which also creates a magnetic field over the brain but one that allows multiple areas of the brain to be stimulated at once. Another improvement over rTMS is that dTMS penetrates the brain up to 4 cm. Each dTMS treatment session is half as long as an rTMS treatment session; lasting on-average 20 minutes. Treatment still needs to be administered every day for between four and six weeks. Over the past ten years the FDA has also moved closer to approving the treatment for anxiety and obsessive compulsive disorder as well.

Neither rTMS or dTMS cause any pain as they are non-invasive treatments. No surgery or anesthesia is used so there is no down time. Sometimes, patients report having headaches during their treatment.

Brainsway for dTMS

A pivotal study was conducted to test the usefulness of dTMS compared to rTMS for the treatment of major depressive disorder and the results were impressive. To summarize the test:

“15 clinically diagnosed individuals were given five daily sessions of deep TMS for four weeks. Of these people, 41.2% were in a state of remission one week after the conclusion of the study, remarks Brainsway. In comparison, of 419 clinically depressed treatment-resistant people who underwent a course of rTMS, 33.4% achieved remission afterwards, concludes a study published in Clinical EEG and Neuroscience. In both instances, treatment was delivered at a high frequency.” The higher percentages of remission in patients who were treated with dTMS lead many physicians to opt for dTMS when choosing which treatment is right for a patient. Although there are many TMS machines on the market, Brainsway is currently the only machine that can be used to perform dTMS.

To Summarize the Main Differences and Similarities Between dTMS and rTMS:

  1. Both dTMS and rTMS are brain stimulation therapies.
  2. Both dTMS and rTMS are approved by the FDA.
  3. Both treatments use slightly different versions of the same technology:
  4. dTMS uses an H-Coil
  5. rTMS uses a figure-8 coil
  6. dTMS penetrates to approx. 4 cm
  7. rTMS only penetrates to approx. 1.5 cm
  8. Each dTMS treatment session (20 minutes) lasts half as long as each rTMS treatment session (40 minutes).
  9. Both dTMS and rTMS need to be administered every day for a period of roughly 4-6 weeks.

Sources:
https://www.ncbi.nlm.nih.gov/pubmed/23185087
https://www.nimh.nih.gov/health/topics/brain-stimulation-therapies/brain-stimulation-therapies.shtml\

For general information, please feel free to email our office at Amanda.Itzkoff@gmail.com. To schedule an appointment, call our offices at 917-609-4990

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