几乎8% of American adults（近2000万人）患有抑郁症，数据表明药物和谈话疗法仅有效治疗约三分之二的抑郁症患者，强调有关留下的差距而没有缓解的差距。从临床上讲，这组无法通过药物找到足够好处的人被认为是“防治透明，让他们没有答案或帮助。然而，一种替代类型的FDA被清除疗法正在上升。

经颅磁刺激, or “TMS”, is a non-invasive method of brain stimulation that relies on electromagnetic induction using an insulated coil placed over the scalp, focused on an area of the brain thought to play a role in mood regulation. The coil generates brief magnetic pulses, which pass easily and painlessly through the skull and into the brain. The pulses generated are of the same type and strength as those generated by magnetic resonance imaging (MRI) machines. The approach is gaining incredible traction and acceptance as an effective therapy for treatment-resistant depression due to its high efficacy and safety – in addition to patients experiencing no systemic side effects.

The ongoing innovation surrounding new types of TMS continues to bring hope to millions of individuals living with mental illness, with a growing number of patients speaking out about the promising results, demonstrating an encouraging shift in the mental health industry.

History of TMS and how it works

尽管使用磁性脉冲刺激人体和身体其他部位以试图治疗疾病的概念可以追溯到100年前，但1985年在1985年引入了第一个现代TMS设备Dr. Anthony Barker。他的设备和研究证明了磁刺激对运动皮层的影响，通过使用磁场来改变大脑的电信号。目前，已经开发了重复电磁诱导的设备，以使不同的参数（包括提高或降低皮质区域的兴奋性的能力）可以修改以研究神经系统和心理条件。

传统TMS使用一个形状形状的线圈，该线圈发出了一个电磁场，能够安全到达参与抑郁症的大脑结构。通过影响这些结构，TMS能够安全地调节其神经活动，从而促进症状缓解并为患者的健康造成贡献。

新兴的TMS技术可以使电磁刺激的更深入和更广泛的渗透，从而导致在目标大脑区域激活更多的神经元。这有助于保持该领域的有效性，而无需将强度提高到风险导致不良副作用的水平。更深，更广泛的领域还可以增强对正确的大脑区域的靶向，从而消除了对复杂的神经运动设备的需求。

尽管标准RTM激活的磁性脉冲仅达到皮层下方0.27英寸（0.7厘米）的深度，但新的TMS技术最多可达到1.25英寸（3.2厘米），在皮质下，它具有独特的能力，能够安全，直接刺激大脑的更深和更广泛的范围，以治疗许多心理健康和成瘾状况。

TMS与传统治疗方法

许多抗抑郁药已被FDA批准用于治疗重度抑郁症（MDD）。选择性5-羟色胺再摄取抑制剂（SSRIS）和5-羟色胺 - 肾上腺素再摄取抑制剂（SNRIS）通常被处方为一线治疗。但是，尽管缓解率相对较高，但超过40％的MDD患者对抗抑郁药无反应and are considered to be treatment-resistant. Medication can also have hard-to-tolerate side effects,从失眠到食欲变化，体重增加和性功能障碍。

The side effects from medication are mostly related to the systemic nature of antidepressants which enter the bloodstream and affect the whole body – and can prevent patients from sustaining a medication regimen. It’s also common for antidepressants to lose their efficacy over time, sometimes without the patient even knowing that it’s happening. These diminishing clinical benefits with successive medications underscore the pivotal addition that TMS serves in the psychiatric practice, providing an effective approach to mental health disorders that does not require medication, particularly for treatment-resistant individuals.

作为一种非侵入性治疗形式，TMS可以在一个人的福祉中带来重大且有益的变化，可以作为独立治疗或与其他形式的治疗（包括药物和心理疗法）一起引入。抑郁症是发达国家残疾的主要原因之一，耐药抑郁症在美国每年影响超过500万患者。

门诊竞技场中的二线治疗有21％的疗效，以实现缓解andfourth-line treatments have a 13% chance of achieving remission。Patients who battle severe depression through multiple unsuccessful medication trials or find the side effects of treatments to be too intolerable to continue the attempts, can greatly benefit from a non-invasive treatment option such as TMS. While no treatment for depression guarantees a permanent cure, the positive effects of a course of TMS treatment have been shown to have significant durability, often a year or more. When relief begins to lessen, follow-up treatments can be conducted.

TMS前进

总体而言，发现继续支持TMS对耐药性精神障碍的功效。临床研究继续将TMS的使用扩展到新的适应症，并允许从业者优化协议，包括刺激参数，治疗目标和TMS交付计划。正在进行的使用神经影像学和脑电图（EEG）的研究为对TMS的治疗耐药性抑郁和治疗机制的更深入了解为基础。

我们将继续看到技术的发展，因为越来越多的精神疾病将得到治疗。随着越来越多的精神科实践继续提供创新的TMS技术，通过治疗MDD，OCD和戒烟将满足更多患者的需求。

Ultimately, TMS will continue to be a crucial non-invasive pillar as an approach in treating a wide variety of psychiatric, neurological and addictive illnesses.

About the author

Dr. Aron Tendler is the chief medical officer ofBrainsWay，深颅磁刺激的开发商（深tms™），唯一已清理FDA的TMS治疗方法可以治疗四个迹象：抑郁症，焦虑抑郁，强迫症和吸烟成瘾。作为CMO，一名医生和具有数十年经验的精神病医生，Tendler博士的研究已在众多同行评审期刊上发表。