How TMS therapy works

Transcranial magnetic stimulation (TMS) therapy is a non-invasive treatment designed to support brain health by gently stimulating specific brain regions involved in mood, cognition, and behavior.

For individuals exploring new treatment options or learning how brain-based therapies work, understanding the science behind TMS can help make the process feel more approachable and less overwhelming.

Here, we explain how TMS therapy works, how it affects the brain, and what patients can expect during treatment. We also introduce how advanced imaging can guide stimulation in a more personalized way. Continue reading to learn more.

What is TMS therapy?

TMS therapy is a non-invasive neuromodulation treatment that uses magnetic pulses to stimulate targeted regions of the brain. These pulses are delivered through a small magnetic coil placed on the scalp and are designed to influence neural activity in areas associated with specific symptoms.

Unlike medication, TMS does not circulate through the body or affect the entire brain. Instead, it focuses on localized brain networks involved in communication, regulation, and processing.

TMS therapy does not require anesthesia, sedation, or recovery time, and patients remain awake and alert throughout each session.

How does TMS work in the brain?

TMS works by generating magnetic pulses that pass safely through the scalp and skull to reach underlying brain tissue. These pulses create small electrical currents that influence how neurons fire and communicate with one another.

In many mental health and neurological conditions, symptoms are associated with disruptions in how specific brain networks function rather than visible structural damage. TMS therapy aims to support healthier communication within these networks by either increasing or decreasing activity in targeted regions, depending on individual needs.

Over time, repeated stimulation can help reinforce more balanced neural signaling and support the brain’s natural ability to adapt and reorganize, a process known as neuroplasticity.

What is fMRI-guided TMS therapy?

fMRI-guided TMS therapy is an advanced approach that uses functional magnetic resonance imaging (fMRI) to help inform where stimulation is delivered. Functional MRI measures patterns of brain activity and connectivity, offering insight into how different regions of the brain communicate.

Rather than relying solely on standardized anatomical landmarks, fMRI-guided TMS therapy incorporates information about an individual’s unique brain network organization. This allows clinicians to align stimulation with specific neural circuits that may be contributing to symptoms.

By using functional imaging as a guide, this approach supports a more personalized understanding of brain function while maintaining the non-invasive nature of TMS therapy.

How the fMRI-guided TMS process works

The fMRI-guided TMS process combines brain imaging with data analysis to support thoughtful treatment planning. Functional MRI captures patterns of brain activity and highlights how networks interact, including areas where communication may be inefficient or imbalanced.

These insights help clinicians understand how the brain functions rather than focusing solely on structure. Stimulation can then be directed toward networks involved in regulation, cognition, or emotional processing, depending on the individual’s brain activity patterns.

In simple terms, fMRI-guided TMS helps identify where brain communication may be less effective and applies stimulation in a way that supports healthier network function. This process emphasizes precision and personalization without changing the patient’s experience during treatment sessions.

What to expect during fMRI-guided TMS treatment

During fMRI-guided TMS therapy, a magnetic coil is positioned on the scalp based on computational brain mapping rather than standardized anatomical landmarks. This targeting is informed by functional MRI data, which helps identify the specific brain networks involved in a person’s symptoms.

The coil delivers brief magnetic pulses that may feel like a light tapping sensation on the scalp. Most patients describe the experience as manageable and do not require pain medication, anesthesia, or recovery time.

Sessions typically last under an hour, and patients can return to normal daily activities immediately afterward. Because fMRI-guided TMS is non-invasive and does not involve sedation, it can be integrated into daily routines with minimal disruption.

Treatment is delivered over multiple sessions, allowing stimulation to build gradually and support longer-term changes in brain connectivity and communication.

Benefits of fMRI-guided TMS therapy

fMRI-guided TMS therapy offers several benefits for individuals exploring brain-based treatment approaches:

• It is non-invasive and does not involve surgery, anesthesia, or medication
• It uses functional brain imaging to guide stimulation based on individual brain connectivity
• It targets specific neural networks rather than relying on generalized stimulation locations
• It is performed on an outpatient basis with no downtime
• It supports neuroplasticity and healthy communication between brain networks

By focusing on how the brain functions and adapts at a network level, fMRI-guided TMS therapy is often explored by individuals seeking a more personalized, brain-based approach to care.

Ready to experience the future of brain health?

Your brain is as unique as your fingerprint, and it deserves care designed with that same level of precision.

At Neurotherapeutix, we combine advanced imaging, neuroscience, and compassionate expertise to help you achieve meaningful, lasting improvement in cognitive and emotional well-being.

Whether you’re seeking relief from a mental health disorder or another neurological condition, our fMRI-guided TMS therapy offers a safe, non-invasive path toward restored clarity, focus, and balance.

Take the next step toward measurable progress and renewed quality of life.

Request an appointment or contact our Manhattan clinic today to begin your personalized care plan.

FAQs about how TMS works

How does TMS therapy work in the brain?

TMS therapy uses magnetic pulses to influence neural activity in targeted brain regions. These pulses help support healthier communication within brain networks involved in mood, cognition, and regulation.

What does TMS feel like during a session?

Most patients feel a light tapping sensation on the scalp during stimulation. Discomfort is typically minimal, and patients remain awake and alert throughout the session.

How long does a TMS session take?

TMS sessions last 20 to 30 minutes with no downtime required. Most patients complete treatment in four to eight weeks.

How many TMS sessions are needed?

TMS therapy is delivered over multiple sessions to support gradual and lasting changes in brain activity. The number of sessions varies depending on individual needs and clinical guidance.

Are there side effects from TMS therapy?

TMS is generally well tolerated. Some patients experience mild scalp discomfort or temporary headache during early sessions, which often improves as treatment continues.