However, for those who do not benefit from these treatments, or who experience only a fractional reduction in symptoms, alternatives have been limited. Over the past few years, Transcranial Magnetic Stimulation (TMS) has emerged as a new option and has advanced from experimental to a more widely available therapy backed by research studies concluding its effectiveness. TMS is non-invasive and surgery-free. It is being increasingly introduced at hospitals and clinics in a number of countries including India, which raises queries in the minds of OCD patients if it can really cure their problem to an extent.
TMS, as the name suggests is a non-invasive tool for “stimulating” (or changing) activity in the brain using magnetic fields. With the help of this magnetic field, certain specific areas of the brain, including those involved in OCD, are targeted, and stimulated. The patient may feel a tapping sensation on their head during procedure, but they are not being “shocked” by electricity.
It is of 2 types:
TMS is meant to be an add-on therapy that patients receive alongside medication and/or ERP.
TMS procedure is generally provided in OPD settings. Treatment sessions are conducted 5 days a week for 4-6 weeks. Initially, each procedure involves a personalized, short “provocation” session where the patient’s OCD symptoms are triggered with intent to engage the brain circuit that will be targeted and magneto-electrically stimulated during the treatment. Following provocation, the actual dTMS treatment duration is approximately 20 minutes. The patient is awake during the procedure. A loud, clicking sound and a ‘tapping’ sensation may be felt during the procedure, for which the patient may be provided with ear plugs.
Reported side effects of TMS include:
A month following treatment, research has found that OCD symptoms reduce in about 45% of patients. This could be over 55% according to some other studies. Some patients return after a period of time for “maintenance” treatment. This may mean returning for singular sessions, once weekly for the next few weeks.
The magnetic field generated during the procedure may interact with metal implants or device in the body. Some examples are:
Aneurysm coils or clips.
Neck or brain stents.
Metal implants in or around ears or eyes.
Tattoos on face or neck that have magnetic ink.
Implanted stimulators, like in heart or brain.
Its always important to check with your doctor and disclose if you have any of the above.
There are a few other treatment options:
Transcranial Direct Current Stimulation (tDCS).
Surgeries are usually the last resort (e.g., Cingulotomy, Capsulotomy, sub-caudate tractotomy). Deep Brain Stimulation (used in the treatment of Depression, anxiety) is also being used in OCD patients. It has been approved by the FDA.