Frequently Asked Questions
What is TMS? What is fMRI-Guided TMS?
We understand that you will have questions about our approach using fMRI and neuronavigational targeting. How is our approach to delivering Transcranial Magnetic Stimulation different?
We use fMRI to image the brain activity of each individual patient and use those images to identify unique brain networks that will guide the design of a personalized TMS treatment plan. We, then, implement the plan by targeting the non-functioning network with the correct coil, and precisely positioning the coil with the infrared Neuronavigation technology.
Please feel free to call us if you cannot find the answer below or simply want to ask more questions.
What is TMS? How does TMS Therapy Work?
We place an electromagnetic coil on specific brain regions based on each patient’s condition, guided by the results of your functional MRI. For example, in depression, we target specific areas within the dorsolateral prefrontal cortex (DLPFC). This target is where the brain regulates mood and activates neurotransmitters using magnetic pulses for 3 minutes. By targeting this area, we also reach deeper mood circuits like the Limbic system (e.g., subgenual anterior cingulate cortex). Which part of the brain does TMS target for depression? The optimal target for treating depression is the dorsolateral prefrontal cortex (DLPFC). However, the exact location of the target within DLPFC is determined by fMRI and is unique to each patient. You can learn more about this in our 4 Step Approach to Wellness.
How long will the Results Last?
fMRI guided TMS will typically last longer than standard approaches due to two scientific reasons. The first is that we are treating the precise area of concern based on the fMRI analysis and the infrared Navigational system. The second reason is that by treating the specific areas, we regain normal functioning in the areas we treat. That in-turn increases the performance of the entire network (intra-network) and the adjacent networks (inter-network). In a sense, by fixing one network, it fixes its interaction with more networks, and the system can help to keep the entire network architecture functioning regularly.
Can fMRI guided TMS treat other brain disorders?
Yes. With our ability to accurately diagnose brain illnesses and our experience with fMRI technology, we can more accurately identify the brain regions and specific networks that are not functioning correctly. With this information, we have shown increased wellness for non-regenerative and degenerative brain disorders. Using TMS therapy, with fMRI analysis, we can effectively treat depression, anxiety, obsessive-compulsive disorder, bipolar, post-traumatic stress disorder, attention deficit hyperactivity disorder, schizophrenia, fibromyalgia/pain, autism spectrum, Alzheimer’s, dementia, stroke, cognitive impairment, insomnia, eating disorders, addictions, migraine, and tinnitus.
What is the availability of the doctors?
We always have a doctor and a knowledgeable provider in our clinic to discuss any questions our patients or their families may have.
Has TMS helped people before, and if so, how has it helped them?
TMS is the most proven non-invasive neuromodulation technique for the treatment of many psychiatric disorders. It has helped thousands of patients over the last decade to gain relief from chronic/treatment-resistant disorders.
How do I know if I am eligible for coverage?
Our treatments are presently not covered by health insurance companies.
Is there a doctor that provides medication management at the clinic?
Yes, Dr. Sandlin Lowe, a psychiatrist with 30 years of experience in treating psychiatric patients, provides clinical management of all our patients.
Will, I, be able to stop all my medications after treatment/will treatment reduce my need for medications?
Elimination or reducing medication is the goal of many patients, and in many circumstances, we have seen complete removal of medications. Often, we find adjustments in medications following the successful relief of symptoms with our approach to TMS. Please be sure to discuss this goal with any of our providers.
Do I need a referral to get an appointment?
No, you can call us directly and make an appointment to discuss your case with our doctors and experts. During the call, we can make a general assessment to see if fMRI guided TMS can help you.
How long will the entire treatment take?
A treatment course takes anywhere from 20-40 sessions at the rate of 5 sessions a week. The nature of the disorder and the progress of the treatment will determine the length of treatment, which is, on average, four to eight weeks. We have other arrangements if you are coming from out of town/state (“express fMRI guided TMS”).
How long would each session take?
Each session usually takes about 20 minutes, with the first treatment taking about 30 minutes. The first session is longer as we set the navigation system to your specific treatment plan.
How many times a week would I have to come in?
Usually, you will come for 5 days a week. On occasions, we treat patients with two sessions a day that reduces treatment days to 3 days a week. For patients who come from out of state, we offer what we call “express fMRI guided TMS,” in which several sessions (up to 5) are delivered each day to reduce the total length of treatments to 1-2 weeks.
Do I need to bring any medical records?
Yes. At your first visit, Dr. Lowe will review your medical record to prescribe a TMS treatment plan for you with the participation of the neuroscientists in the clinic. An essential piece of information is your history of mental health medications.
Can I use an MRI that I had done a few months ago?
Unfortunately, no. We are performing a Functional MRI which uses a specific protocol for us to identify your unique brain networks that are not functioning correctly. The type of sequences used are not the standard clinical sequences used by radiologists.
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