What are TMS (Transcranial Stimulation) and MERT (Magno-EEG Resonant Therapy)?

Transcranial magnetic stimulation (TMS) is a non-invasive, non-surgical method to excite neurons in the brain. The excitation is caused by weak electric currents induced in the tissue by rapidly changing magnetic fields (electromagnetic induction). This way, brain activity can be triggered or modulated without the need for surgery or external electrodes. Repetitive transcranial magnetic stimulation is known as rTMS. TMS is a powerful tool in research and diagnosis for mapping out how the brain functions, and has shown promise for non-invasive, non-surgical treatment of a host of disorders, including depression and auditory hallucinations without the use of medication.

Magno-EEG Resonant Therapy (MERT) is an advanced form of rTMS developed by Dr. Yi Jin and used exclusively at Brookside Institute NeuroScience Center. The main difference between MERT and rTMS is the use of an electroencephalogram (EEG) or brainwave analysis to identify the precise intensity, stimulus frequency, location, duration and maintenance plan to bring the brainwaves back into normal patterns. Standard rTMS protocols use the same frequency, location and duration on all patients in the study without first analyzing the individual patient’s brainwave patterns. With MERT, a customized treatment is created for each patient.

Where have TMS and MERT been researched?
TMS was developed in England and is currently being actively investigated at major universities throughout the world such as Harvard, Yale, Georgetown University Medical Center, The Medical University of South Carolina, Stanford University, Helsinki University Central Hospital, University of California Irvine and the University of Sydney.

Has MERT (TMS) been approved by regulatory agencies?
Several TMS/rTMS devices are approved by the US Food and Drug Administration (FDA) for stimulation of peripheral nerve and, therefore, can be used "off label" by individual physicians to treat brain disorders, essentially in any way they believe appropriate, analogous to the off label use of medications. In January of 2007, the FDA’s Neurological Devices Panel concluded that TMS treatment is safe but requires further research to demonstrate efficacy.

In 2002, Health Canada approved TMS as a treatment for medication-resistant depression.

Will insurance pay for MERT?
Because MERT (TMS) has not been approved by the FDA, but is an off-label use of an approved medical device, most U.S. insurance companies will not pay for MERT (TMS) treatments.

Is MERT (TMS) safe? Are there any common side effects?
TMS was introduced in the mid 1980s. It is generally agreed to be free from side effects when proper procedures are followed. Over the years since introduction, safety guidelines have been developed which minimize risks. The main complaint from a small percentage of patients is headache during and immediately following the stimulation session. This can be alleviated with over-the-counter pain medications such as acetomycin (Tylenol), aspirin or ibuprofen. It is believed that these headaches are caused by the inadvertent stimulation of nearby muscle groups, which results in tension headaches. Another common problem is ringing in the ears caused by the noise of the stimulating coil, so earplugs are typically worn during the procedure.

Seizures are the major possible risk associated with TMS, although they have only been encountered in a few patients thus far. While TMS safety guidelines established in 1993 and revised in 1996 go a long way to reducing the chances of seizure, the possibility still exists.

What diseases/disorders have MERT (TMS) been successful in treating?
TMS is currently being studied as a potential treatment for many disorders including depression, schizophrenia, posttraumatic stress disorder, obsessive-compulsive disorder, migraine headaches, autism, stroke, and chronic neuropathic pain. Numerous studies have been published in peer reviewed journals which indicate that TMS is even useful in treating cases of depression which are untreatable with any other therapy. Some have called TMS a "life saver."

Brookside Institute NeuroScience Center