Deep TMS and Major Depression
Major depression is a serious brain disorder that complicates the individual’s life. In addition to drugs and psycho-social intervention, TMS is also a method administered particularly for patients who are treatment-resistant, complain about the side effects of drugs, have liver-kidney problems or who are pregnant and puerperal. In the major depression protocol, thanks to the magnetic field applied on the left dorsolateral prefrontal cortex (DLPFC) of the brain, the cortical blood flow, glucose and oxygen consumption, which have slowed down due to depression, go back to their usual speed. This causes an antidepressant effect. The brain areas, where significant changes have been observed following the TMS application, are the left anterior cingulate cortex, left insula, left upper temporal gyrus and right angular gyrus. An increase of volume in these areas and a decrease in the severity of depression have been found to be correlated. In addition to the aforementioned areas, Deep TMS is also capable of reaching the nucleus accumbens and frontal tegmentum area due to the fact that it effects a deeper and wider area. This difference between standard TMS and Deep TMS makes Deep TMS more effective in the treatment of major depression.
Deep TMS and Obsessive Compulsive Disorder
Obsessive Compulsive Disorder (OCD) is defined as intensely disturbing thoughts and repetitive behaviors. According to the neurobiological model, OCD is associated with motor areas, cortico-striato-thalamo-cortical pathways, prefrontal cortex and orbitofrontal cortex. Deep TMS aims at the medial prefrontal cortex and anterior cingulate cortex. Emotional and cognitive processes become integrated, while the there is an improvement in the control, attention, planning and short-term memory functions of the patient through the deep stimulation of such areas.
Deep TMS and Bipolar Disorder (Manic Depression)
In patients with bipolar disorder, Deep TMS is applied in the depression episode. Similar to the major depression protocol, the target area in the bipolar depression is also the left dorsolateral prefrontal cortex (DLPFC), and a high frequency is applied. The studies have reported that the patient’s depression disappeared following the treatment, and that no manic attacks were observed during the tests administered weeks later.
Deep TMS and Asperger’s Syndrome
Asperger’s Syndrome is an Autism Spectrum Disorder, which causes impairments in social relations and communication. In addition, slow, restrictive or recurring behaviors are observed. It is neurobiologically put forward that there is an imbalance in cortical stimulation or inhibition in the brain. Anterior cingulate cortex, left auditory center and low GABA level in the left motor area have been found to be related to social consciousness, mood and motor stereotypes. Imbalanced electrical zones in such areas are equalized, and a decrease is observed in the symptoms thanks to Deep TMS.
Deep TMS and Post-Traumatic Stress Disorder (PTSD)
Post-Traumatic Stress Disorder is a complex disorder consisting of perceptual, cognitive, emotional, physical and psychological problems. In neurobiological terms, it is considered that PTSD is associated with medial prefrontal cortex, hippocampus and amygdala. The disorder being associated with sub-cortex limbic structures causes a need for a deeper stimulation. Deep TMS is considered a safe method in stimulating such target areas.
Deep TMS and Cocaine Addiction
It is observed that usage is recurrent in cocaine addiction. It is considered that this condition is caused by a low dopamine level in the nucleus accumbens, and the studies have shown that the nucleus accumbens is modulated by the stimulations targeting the dorsolateral prefrontal cortex. In cocaine addiction, Deep TMS is applied on the medial prefrontal cortex and anterior cingulate, and this is found to be successful in preventing withdrawal and recurrence.
Deep TMS and Panic Disorder
Panic disorder is defined with recurring and unexpected panic attacks, and maladaptive behaviors developed against such attacks. In neurobiological terms, it is explained by the decrease of the activity in the prefrontal cortex, and impaired hyperactivity in the brain structures associated with fear (amygdala). Deep TMS is implemented on this area at high frequency due to the slowdown in the right dorsolateral prefrontal cortex. On the other hand, the low frequency, which is administered on the amygdala with the opportunity to provide deep stimulation, enables different areas of the brain to be balanced.
Deep TMS and Tourette’s Syndrome (Tics)
Tics are stereotypical, fast, arrhythmical, recurring motor movements and articulations that occur in episodes. Supplementary motor area (SMA) controls the relations between the limbic system and cognitive processes. Neuroimaging studies have reported an excessive activity on this area immediately before the occurrence of the tics. Deep TMS is implemented on the SMA bilaterally on patients with Tourette’s Syndrome.
Deep TMS and Schizophrenia (Negative Symptoms)
Regression or disappearance of specific capabilities, stagnation in affection, movements and facial expressions, or a decrease in speech, indifference, anhedonia and anti-sociality are negative symptoms observed in patients with schizophrenia. These symptoms are also observable in major depression, Parkinson’s, Alzheimer’s and epilepsy. It is considered to be caused by the slowdown in the frontal cortex and anterior cingulate area. Deep TMS aims to decrease the negative symptoms by eliminating the lack of dopamine in the prefrontal cortex through high-frequency stimulation.
Deep TMS and Schizophrenia (Auditory Hallucinations)
Auditory hallucinations in schizophrenia may cause stress, functional incapability, uncontrollable behaviors and violence in the patient. Auditory hallucinations associated with the speech perception area occur due to excessive activity in the left temporoparietal cortex. Thus, a low-frequency Deep TMS is applied.
Deep TMS and Alzheimer’s
In Alzheimer’s, the Deep TMS practice aims to restore the impaired plasticity in the dorsolateral prefrontal cortex. It is considered that it heals the cognitive functions through the stimulation of the neurons.