Brookside Institute :: TMS and MERT – FAQ

What is TMS?

Transcranial magnetic stimulation (TMS) is a non-invasive method of exciting neurons in the brain using a controlled, weak electrical current created by rapidly changing magnetic fields. Repetitive transcranial magnetic stimulation (rTMS), focusing the magnetic fields in a specific area repeated over a period of time and/or during multiple sessions, has shown promise in several clinical studies for the treatment of mental health disorders such as depression(1) and schizophrenia(2). In one study, rTMS reduced cravings for cocaine(3). Scientists have been studying brainwaves and analyzing the links between psychological disorders and abnormal brainwave patterns for decades. Clinicians and physicians are excited about the therapeutic applications of rTMS because it is non-invasive, unlike other implanted devices such as the Vagnus Nerve Stimulation (VNS) System, and does not have the pain and potentially devastating side effects of Electroconvulsive Therapy (ECT or "shock therapy").

What is MERT?

Magno-EEG Resonant Therapy (MERT) is repetitive transcranial magnetic stimulation that is individualized for each patient based on his or her unique brainwaves (recorded by an electroencephalogram "EEG"). MERT was developed by Yi Jin, M.D., Director of Brookside Institute’s NeuroScience Center and Trung Thai, M.D., F.A.C.G.S., Medical Director of Brookside Institute. Unlike rTMS, which uses the same frequency and location to treat all patients, the psychiatrists and clinicians at Brookside Institute analyze the patient’s EEG to create a treatment plan with the exact frequency and location of the magnetic fields needed to bring the patient’s brainwaves into a normal pattern.

Has TMS been approved by the FDA?

TMS devices have been approved for decades as a tool for diagnosing neurological disorders. A TMS device has been approved by the FDA to treat Major Depressive Disorder in adults who have not had improvement from antidepressant medication. In order to be approved by the FDA, the device has to be both safe and effective in treating the disease for which it is marketed. The approved device for depression, NeuroStar TMS System, is one of several TMS devices manufactured in the U.S. Each manufacturer must apply separately for the additional approval to treat depression based on substantial equivalence to the NeuroStar device. MERT is a proprietary physical treatment based on the same principle of TMS but individualized in stimulus frequency, intensity, and location according to subject’s EEG profile and motor threshold. Brookside Institute uses a TMS device manufactured by Medtronics because it provides more choices of coil types and supports an interface for 3rd party software that allow us to individualize the treatment protocol.

Is MERT (TMS) safe? Are there any common side effects?

Based on the results of the studies submitted to the FDA, the most common side effect is scalp pain or discomfort at the treatment area during active treatments, which is mild and generally relieved by an over-the-counter analgesic, such as acetomycin (Tylenol). There have been no reports of weight gain, sexual dysfunction, sedation, nausea or dry mouth, which are common side effects of anti-depressant medications.

How many treatments are needed for depression?

The number and frequency of MERT sessions vary from patient to patient, as determined by the individual’s treatment team at Brookside Institute. Most patients begin to feel better after a few sessions, with best results achieved after five daily sessions per week for four weeks. The affects of MERT are not permanent and patients may require additional maintenance sessions.

What is the cost for MERT? Will insurance pay for it?

ABrookside Institute provides MERT as part of a comprehensive treatment for depression and/or substance abuse with a co-occurring disorder. Prices for these treatments vary depending on the length of treatment and level of care (residential or outpatient). Most insurance companies will not pay for off-label uses of approved devices; however, now that the FDA has approved TMS for depression, insurance companies will be more likely to cover this procedure in the future.

If you are looking for serious treatment for your depression, please give us a call (866) 405-8787.

Footnotes

(1) Paul B. Fitzgerald, M.B.B.S., M.P.M., Ph.D., F.R.A.N.Z.C.P., Jessica Benitez, B.Sci., Grad. Cert. Clin. Nurse ( Psych.), Anthony de Castella, B.A., Dip. App. Sci., Z. Jeff Daskalakis, M.D., F.R.C.P.(C.), Timothy L. Brown, Grad. Dip. Clin. Nurse (Psych.) and Jayashri Kulkarni, M.B.B.S., M.P.M., Ph.D., F "A Randomized, Controlled Trial of Sequential Bilateral Repetitive Transcranial Magnetic Stimulation for Treatment-Resistant Depression" Am J Psychiatry 163:88-94, January 2006 doi: 10.1176/appi.ajp.163.1.88

(2) Yi Jin, Steven G. Potkin, Aaron S. Kemp, Steven T. Huerta, Gustavo Alva, Trung Minh Thai, Danilo Carreon, and William E. Bunney Jr."Therapeutic Effects of Individualized Alpha Frequency Transcranial Magnetic Stimulation (TMS) on the Negative Symptoms of Schizophrenia" Schizophrenia Bulletin, DOI:10.1093/schbul/sbj020

(3) Joan Albert Camprodon, José Martínez-Raga, Miguel Alonso-Alonso, Mei-Chiung Shih and Alvaro Pascual-Leon "One session of high frequency repetitive transcranial magnetic stimulation (rTMS) to the right prefrontal cortex transiently reduces cocaine craving" Drug and Alcohol Dependence Volume 86, Issue 1, 5 January 2007, 91-94 DOI:10.1016/j.drugalcdep.2006.06.002