Project Description

Theta Burst Stimulation Therapy – Q&A

Theta-burst stimulation is a rapid form of repetitive transcranial magnetic stimulation (rTMS), which uses a magnetic field to stimulate the brain area called the dorsolateral prefrontal cortex. This area plays a central role in mood regulation, decision making, and memory.  Theta-burst stimulation requires a much shorter treatment time than conventional rTMS.

Three-minute magnetic brain stimulations can be repeated multiple times during one treatment session; conventional rTMS follows a 7-week, 35-minute session protocol.  The treatment is conducted in a comfortable chair with the patient awake and relaxed.  The magnetic field produced by theta-burst stimulation is about the same strength as that generated by an MRI. 

rTMS is FDA approved for treatment-resistant depression.  Overseas, it is approved for chronic pain, migraine, and obsessive-compulsive disorder.  rTMS is the subject of intensive research and has shown significant benefit for a number of conditions, including complex regional pain syndrome, neuropathic pain, spinal pain, and migraine.  It has also been successfully used for the treatment of addiction, post-traumatic stress disorder, and traumatic brain injury, and it has been studied for use in such conditions as Alzheimer’s disease and multiple sclerosis.

The latest research indicates when combined, theta-burst stimulation and ketamine infusions may help some of the most treatment-resistant patientsSingle-pulse magnetic stimulation is now FDA approved for migraine.  Repetitive transcranial magnetic stimulation has been shown to be clearly effective for chronic migraine and has been shown to be beneficial for complex regional pain syndrome (CRPS).  In the United States, most insurance carriers will cover the cost of treatment for rTMS for treatmentresistant major depression. 

Three-minute theta-burst stimulation treatments may be conducted on a daily basis.  For more rapid symptom control, it can be conducted with up to five stimulations in one treatment session.  Research has shown that special protocols consisting of multiple treatment sessions in one day can eliminate suicidal thoughts.  Rapid theta-burst stimulation protocols may require only four to six treatment sessions; conventional rTMS requires 35-minute sessions five days a week for seven weeks. 

Most depressive symptoms see improvement over two weeks, but some may take six weeks after the treatment is started for maximum improvement or remission of clinical depression.  Treatments may be repeated in six months if symptoms reappear.  For patients with chronic pain, studies generally show noticeable improvement even after the first treatment session. 

Theta-burst stimulation may be helpful for multiple intractable chronic pain conditions, depression, PTSD, OCD, and traumatic brain injury.  The treatment is rapid, safe, generally comfortable, and may be utilized to treat multiple conditions at the same time.  Most patients with these types of conditions will be good candidates for treatment.  It is generally very well tolerated, although some patients experience temporary mild headaches on certain protocols. 

In the future, theta-burst stimulation will likely be a first-line treatment for a number of neuropsychiatric and chronically painful conditions due to its superior safety and effectiveness.

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