rTMS | 奧馬臨床心理·綜合治療中心

rTMS (repetitive Transcranial Magnetic Stimulation)

OMA and Neuroway work hand-in-hand to introduce Repetitive Transcranial Magnetic Stimulation (rTMS) from EU to provide therapeutic treatment to the clients in need. The therapeutic effect is remarkable. rTMS was approved for the treatment of depression in the United States in 2008 and has accumulated a wealth of case data over the years, with thousands of clinics specializing in rTMS treatment across Europe and the United States.

rTMS has been adopted to treat the following groups, including Insomnia, Dementia, Parkinsonism, Stroke (CVA), Depression, Anxiety disorder, Obsessive complusive disorder (OCD). In addition, some studies have pointed out that rTMS also has the effect of enhancing memory, delaying degeneration, and enhancing learning in the brains of healthy people.

Our Professional Team is consisted of medical specialists, clinical psychologists, occupational therapists, and qualified TMS technicians. All treatment provided are based on evidence-based research and clinical protocol, which secure the safety, effectiveness and efficiency of the treatment you received.

For any enquiries and bookings, please feel free to contact us at 2110 2081 or WhatsApp 9794 0127 or email at info@oma-counseling.com

What is rTMS?

repetitive Transcranial Magnetic Stimulation (TMS) is a non-invasive, highly safe nerve stimulation procedure that rarely causes side-effect. It uses a rapidly changing magnetic field to induce an electric current, which then effectively stimulates the cerebral cortex or peripheral nerves. Using the magnetic pulse of rTMS to stimulate the emotional area of the brain can make the brain release serotonin and other neurotransmitters, activate the lower level area, change the activity of cortical neurons, and then activate the brain and improve various symptoms.

Safety of rTMS?

It is clinically classified as a non-invasive treatment. The treatment itself does not involve destroying the skin or the body, and will not cause direct damage to the muscles, nerves, and blood vessels of the human body, and does not require prior preparations such as anesthesia.
rTMS has been adopted for more than 20 years, the proportion of people with epilepsy induced is very low. Under standard operation, including high-risk groups (people who already suffer from epilepsy), the overall risk is about 3/10,000 to 9/10,000, which is regarded as a very low risk.
The TMS technology has been approved by the U.S. Food and Drug Administration (FDA) and issued by the European Union (CE-marked), confirming its safety and therapeutic efficacy.

Who are not suitable for rTMS?

Have a history of epilepsy
Severe spinal cord injury
Metal implants above the neck
Wear artificial electronic ear
Equipped with a cardiac pacemaker
Equipped with a cardiac vascular stent
Aneurysm or brain injury

How long is the treatment?

More than 20 treatments per four weeks will have the best result

According to a 2017 literature review and synthesis analysis by European Psychiatry, the effect of rTMS treatment becomes more significant with increasing frequency. For example, rTMS 5 times a week reduced the depression score by an average of 0.43 standard deviations, and after 20 treatments, the depression score decreased by an average of 2.74 standard deviations.

Are there any side effects of rTMS? What other therapeutic or health care uses does it have?

Because rTMS treatment is a treatment for the brain, rather than a drug-like systemic chemotherapy, rTMS side effects are relatively few and safe, except for a few patients who have headaches. However, the only thing to note is that rTMS has a very small chance of inducing epilepsy. Patients with a history of epilepsy, alcohol addiction, and other drugs or diseases that can easily induce epileptic states, brain trauma, or metal implants such as electronic ears and rhythm devices are not suitable for rTMS.

Effectiveness for people with obsessive-compulsive disorder (OCD)?

Approximately 46.2% of OCD patients who did not respond to medication had a clinically positive response to rTMS. Most of them had at least 30% improvement in their symptoms.
Another recent study indicated that approximately 50% of people with OCD responded positively to rTMS, and all had greater than 50% improvement in their symptoms.

Effectiveness for People with Autism?

The autism spectrum refers to a range of symptoms of a neurodevelopmental syndrome. Patients can have different degrees of autism tendencies. Currently, autism, Asperger's Syndrome and Pervasive Developmental Disorder (PDD-NOS) and Childhood Disintegrative Disorder are included on the autism spectrum.

Clinical studies have pointed out that autism is related to abnormal brain development and genetic factors. In recent years, many clinical treatment centers around the world have begun to use magnetic brain stimulation, a non-invasive method, to understand the etiology of autism. Clinical studies have also pointed out that magnetic brain stimulation also has clinical therapeutic potential in the treatment of autism.

Effectiveness for People with Attention Deficit or Hyperactivity

Disorder(ADHD)?

ADHD is one of the most common neurodevelopmental disorders. 10% to 30% of these patients do not respond to standard medical treatment and thus suffer adverse physical and mental developmental consequences. A randomized, controlled pilot study evaluating the safety and efficacy of TMS noted significant improvement in adolescent ADHD patients treated with rTMS, without any major adverse effects. Systematic analysis studies also suggest that rTMS and tDCS may be a promising treatment for children and adolescents with neurodevelopmental disorders.

Clinical studies have found that magnetic brain stimulation therapy can specifically treat the neurological dysfunction caused by ADHD, and magnetic brain stimulation has been rated as safe for use in children over two years old, with good tolerance and safety. There are still several large-scale medical studies on ADHD and magnetic brain stimulation in progress around the world, and it is believed that there will be more research data to support the potential use of non-invasive brain stimulation in ADHD.

Effectiveness for People with Parkinsonism?

Parkinson's disease is the second most common neurodegenerative disease after Alzheimer's disease. In addition to motor symptoms such as bradykinesia, rigidity, postural instability, and gait disturbance, Parkinson's disease patients are usually accompanied by a series of non-motor symptoms such as depression, cognitive dysfunction, and autonomic dysfunction. Multiple high-frequency rTMS performed on the frontal cortex improved cognitive function in Parkinson's patients, including memory, attention, and language.

Effectiveness for people with depression?

A large number of studies have been carried out around the world to show that the application of rTMS to the frontal lobe region of the brain has antidepressant effects. There are more than 30 studies on depression in adults, showing that rTMS are effective treatments for depression. It has been suggested that rTMS works by modifying and rebalancing the activity of brain networks, which produces changes in the brains of people with depression. rTMS is now an approved treatment for depression in countries including Australia, USA, Canada, Israel and the UK. rTMS was approved for the treatment of depression in the United States in 2008, and the Taiwan Ministry of Health and Welfare also approved it in 2018 to treat depression.

Comparison of rTMS with antidepressants and placebo?

Medical journal JAMA pointed out that the effect of antidepressant drugs was approximately 1.37 to 2.13 times that of placebo; the bilateral rTMS treatment was 3.96 times that of placebo; the effect of provocative TMS treatment was 4.66 times that of placebo.

• Approximately 60% of depressed patients who do not respond to medication have a clinically positive response to rTMS. About a third of them had their symptoms completely gone.

• In the first onset cohort, approximately 95.5% responded positively to rTMS, while approximately 68.2% recovered from symptoms.

• 2010 American Psychiatric Association Clinical Treatment Guidelines included TMS as a treatment for patients with moderate to severe depression.

Effectiveness for people with Dementia?

rTMS has been studied as a treatment for patients with cognitive impairment/degeneration. Multiple studies point to positive effects of rTMS on people with cognitive impairment, whether it be vascular dementia, Alzheimer's, mild cognitive impairment or other types of dementia. Generally, rTMS is combined with cognitive training on the disease.

After three to four weeks of treatment, the patient's cognitive ability will gradually increase, and this progress may be manifested in various aspects, for example, the patient may become easier to speak, remember things, and can be more focused on daily tasks. (Note: This improvement should not be assessed until the full six-week course of treatment and cognitive training has been completed.) After the course of treatment, the physician will discuss follow-up maintenance options with the family. In clinical studies, improvements in cognitive levels were found to be maintained for up to a year.

Effectiveness for stroke patients?

Cerebral stroke is a problem with cerebral blood vessels. Due to the infarction or hemorrhage of blood vessels in the brain, the brain tissue cannot receive oxygen and nutrients in time, and the affected nerve cells are necrotic, resulting in various body handicapped caused by nerve damage.

Because the activities of daily living and cognitive abilities of patients are greatly affected after a stroke, studies have shown that even if a stroke patient receives emergency treatment, there will still be 15% to 30% of physical disabilities. rTMS is a potential tool for stroke treatment. Many studies have reported that rTMS has the potential to improve motor function in patients. Although there is still a lot of research going on, rTMS has proven to be a promising stroke rehabilitation treatment.

rTMS can adjust the cortical excitability of the cerebral cortex, selectively enhance or inhibit the function of specific areas of the brain, so as to achieve the regulation of brain function and neuro-plasticity, thereby improving stroke patients. The ability to perform cognitively or behaviorally.

In summary, brain stimulation can:

• Increase the excitability of the injured part of the brain, thereby increasing the recovery time of the injured part

• Inhibits competition for non-injured parts of the brain, giving damaged parts a better chance of repairing

• Inhibition of non-injured parts of the brain also improves response rates in chronic stroke patients

Effectiveness for People with Insomnia?

In a systematic study in 2021, 20 studies on the effectiveness of rTMS and insomnia were analyzed. Nearly all studies showed that rTMS was effective in improving subjective or self-reported sleep quality.

Effectiveness for People with Social Anxiety Disorder?

Social anxiety disorder is one of the most common anxiety disorders, affecting about 7% of the population! And many people with social anxiety disorder experience symptoms for 10 years or more before seeking professional help. People with social anxiety disorder are afraid of being judged and/or negatively evaluated, they fear being ignored or rejected in social situations. Studies have shown that receiving daily high rTMS for four consecutive weeks can make brain activity more balanced, opening up a potential treatment option for the treatment of social anxiety disorder.