BrainsWay is the company that designed the patented H-coil for deep brain stimulation. They are the gold standard of TMS technology.
BrainsWay supplies the deep TMS machines to Prime TMS for administration of depression treatment. In addition, they are the company that trained and certified our facility prior to opening.
Most insurances cover deep TMS therapy. You likely qualify for insurance coverage if you have:
- a current diagnosis (within last 6 months) of Major Depressive Disorder, moderate or severe
- no metal implants in head or neck (metal dental fillings are okay)
- no history of epilepsy
- no recent or active alcohol/drug abuse
- already tried at least four medications for depression
- been referred to Prime TMS for deep TMS treatments by a psychiatrist or other healthcare provider
To check your coverage, visit our Insurance page.
You can opt to pay out-of-pocket to receive deep TMS therapy. While the total cost of receiving 36 treatments can be high, it is Prime TMS’s mission to expand access to deep TMS treatment. If you would like to receive TMS, we want to help.
Expanding accessibility to treatment means expanding affordability. Prime TMS offers 25%, 50% and even 75% discounts based on Federal Poverty Guidelines. In addition, Prime TMS has established payment plans and financing options through Enhance Patient Financing for qualified patients to make self-pay plans affordable and hassle-free.
Deep TMS is a good option for many people, but not everybody. Some factors such as an epilepsy diagnosis, metal implants in your head or neck, and drug or alcohol usage could prevent you from being able to receive treatment. Contact Prime TMS today to discuss your options.
- More effective, FDA-approved depression treatment
- Non-pharmacologic (no drugs, medication)
- Thirty-six twenty-minute outpatient treatment sessions (other forms of TMS take 45-90 minutes per session)
- Stimulates deep brain structures unlike earlier forms of TMS, such as rTMS
- Return to daily activities
- Additional advantages when compared to ECT (see below)
The most common side effect is slight risk of fatigue or headache following initial treatments (first week).
There is a very rare (<0.2%) chance of seizure during the session, but this can be mitigated by avoiding excessive alcohol intake 24 hours prior to treatment. Deep TMS has no long-term, adverse side effects.
ECT (electroconvulsive therapy) uses electrically induced seizures. Patients have to be put under general anesthesia and the treatment comes with significant side effects such as memory loss.
Deep TMS is much safer and more effective. It uses magnetic pulses to stimulate targeted areas of the brain. Deep TMS does not require anesthesia, does not require much downtime and has no significant side effects.
Patients can usually remain on their current depression medications. Deep TMS can be used as a replacement or supplement to antidepressants. Because deep TMS has less side effects, some patients opt to taper off of antidepressants during deep TMS. A decision can be made about treatment regimen with your doctor or Prime TMS.
If you are referred to Prime TMS by a psychiatrist or other mental health provider, you will continue your relationship with the referring practitioner during deep TMS Therapy. Decisions regarding concurrent medication management and treatment are made with your referring provider, as well as continued follow-up care.
Response and Remission rates are measured using standardized scales to determine effectiveness of depression treatments.
- Response means a patient’s depressive symptoms improve by at least 50%.
- Remission is achieved when a patient’s symptoms are considered normal mood disturbances or mild.
At Prime TMS, we use both Beck’s Depression Inventory (BDI) and the Patient Health Questionnaire (PHQ-9) to identify if clients have achieved Response or Remission. Currently, Prime TMS is seeing a Response rate of 88.2% and a Remission rate of 52.9% at our Lawrence facility.
Though we have our own results, we encourage you to look at original studies that granted both TMS and deep TMS FDA-approval. These studies report different numbers than our individual facility, and both were done in a clinical setting that allows a more direct comparison.
There have been no studies conducted to actively compare deep TMS and TMS. However, for FDA-approval, each therapy underwent similar large-scale clinical trials. While results are not directly comparable, they provide a general idea as to the effectiveness of each method.
Both the TMS and deep TMS studies reported their subjects’ Remission rates after receiving 4 weeks of treatments. In deep TMS subjects, 32.6% reached Remission, while only 7.1% to 9% of the subjects receiving TMS therapy reached Remission. The TMS study did not report their rates of Response, but in the deep TMS study, a Response rate of 38.4% was achieved. Using these numbers, we know 71% of the subjects in the original deep TMS study had between 50% and 100% relief from depressive symptoms.
Studies show that, “symptom relief…was critically dependent on the depth of stimulation.” The structures that play a large role in depression are situated deep within the brain’s prefrontal cortex, so when the electric field is deeper, the “antidepressant effects of TMS” are enhanced.
Due to the smaller range of TMS and the figure-8 coil, its targeting is much more localized. One study indicates that the target area is missed in up to two-thirds of subjects in clinical trials. This indicates that nearly 70% of people who receive standard TMS treatment (vs. deep TMS) aren’t receiving stimulation in the area that would help alleviate symptoms.
Comparatively, the H-coil stimulates a broad enough area to assure stimulation to the target area. While both treatments use the same targeting procedure, deep TMS is more likely to hit necessary brain structures for effective treatment.
In addition, the figure-8 coil is prone to coil movement during treatment, diminishing its antidepressant effects even more. Deep TMS treatment minimizes coil movement, preventing loss of contact between the coil and the client’s head. Paired with the H-coil’s deeper and broader field, this makes deep TMS a far more effective depression treatment.
You can contact us via email at firstname.lastname@example.org or by phone at (785) 371-4921. If you are a good candidate for deep TMS, we will make a consultation appointment for you as soon as possible to make sure you can get effective treatment quickly.
You may also print off a Referral Form to take to your psychiatric healthcare provider to discuss whether deep TMS is a good option of you. Have them fax it (888-965-5147) to our office and we will follow up with you to schedule your consultation!
A PHQ-9 is a questionnaire given to patients to diagnose the presence and severity of depression.
Results from each of the nine questions is totaled to receive a total score used to determine the existence of depressive symptoms.
The scoring is recorded as follows:
- 0–4: none to minimal
- 5–9: mild
- 10–14: moderate
- 15–19: moderately severe
- 20–27: severe