Conventional TMS
At Bridge, we use advanced Transcranial Magnetic Stimulation (TMS) to non-invasively map and modulate the precise deep-brain circuits responsible for mood, anxiety, and compulsive behaviors. Led exclusively by specialized physicians, our targeted protocols offer an evidence-based path to lasting remission - built entirely around your unique biology.
What is Conventional TMS?
Conventional TMS, often referred to as repetitive transcranial magnetic stimulation (rTMS), delivers repeated magnetic pulses through a treatment coil positioned near the scalp.
These magnetic pulses pass through the skull and produce small electrical currents in targeted areas of the brain. In the treatment of major depressive disorder, for example, conventional TMS commonly targets the left dorsolateral prefrontal cortex (dlPFC)- a region involved in mood regulation and other cognitive and emotional processes. In the treatment of obsessive compulsive disorder (OCD) - conventional TMS targets the dorsomedial prefrontal cortex (dmPFC).
The U.S. Food and Drug Administration (FDA) first cleared a TMS system for the treatment of Smoking Cessation, Major Depressive Disorder in 2008 and Obsessive Compulsive Disorder in 2018.
Who May Be Considered for Conventional TMS?
TMS is commonly considered for adults with Major Depressive Disorder or Obsessive Compulsive Disorder whose symptoms have not improved sufficiently with first-line treatments. Whether TMS is appropriate depends on the individual.
Before treatment, a clinician should conduct an evaluation that considers factors such as:
Current symptoms and diagnosis
Previous treatment trials
Response to psychotherapy and other treatments
Current medications
Medical and psychiatric history
Previous TMS treatments, if applicable
Implanted metallic or electronic devices
Ability to complete treatment schedule
Ability to complete treatment schedule
What does Conventional TMS Treatment Look Like?
01
Evaluation and Treatment Planning
Treatment begins with an initial evaluation and planning process. Your physician determines the appropriate stimulation target and intensity and may measure your motor threshold to help individualize the strength of stimulation.
02
Conventional TMS Sessions
During treatment, you sit in a treatment chair while the magnetic coil is positioned against the scalp. The device delivers repeated magnetic pulses according to the prescribed protocol, and you remain awake throughout the session.
03
Treatment Course and Response
Conventional TMS is usually delivered over several weeks, commonly 5 days per week for approximately 4–6 weeks. The exact number of sessions can vary based on your clinical circumstances, response, device, protocol, and insurance authorization. Some patients may require additional sessions to reach their maximum clinical benefit.
Why Evidence-Based TMS Matters
TMS is more than placing a magnetic coil against the head.
High-quality TMS care involves appropriate diagnosis, patient selection, safety screening, individualized treatment parameters, accurate targeting, symptom monitoring and ongoing clinical oversight.
A thorough TMS evaluation should leave patients feeling informed and supported. Physicians work with patients to walk through key aspects of their care, including:
- Explaining the specific diagnosis and clinical rationale for choosing TMS.
- Outlining the specific protocol being used and the evidence behind it.
- Setting clear expectations for how progress will be monitored.
- Discussing a strategy for next steps if the treatment does not yield the desired response.
These questions help turn TMS from simply a procedure into part of a thoughtful, individualized mental-health treatment plan.
Considering TMS?
If depression has continued despite previous treatment, an evaluation can help determine whether conventional TMS - or another treatment approach - may be appropriate.
At Bridge Physicians Group, treatment decisions begin with understanding the individual: their symptoms, previous treatments, medical and psychiatric history, goals and response to care.
TMS works best as part of a comprehensive care plan, tailored specifically to a patient's unique history and clinical needs.
This information is provided for educational purposes and is not a substitute for individualized medical advice, diagnosis or treatment. TMS eligibility, treatment protocols and expected outcomes vary by patient. A qualified healthcare professional should determine whether TMS is appropriate for you.
Faq
Frequently Asked Questions
What are the side effects?
TMS is generally considered well-tolerated, but it is not completely free of risks or side effects.
Common treatment-related side effects can include:
Scalp discomfort
Headache during treatment
Tingling or uncomfortable sensations during stimulation
Facial muscle movement or twitching during treatment
These effects may become less noticeable as patients become accustomed to treatment.
Seizure is a recognized but uncommon serious risk associated with TMS. Appropriate patient screening and adherence to established stimulation parameters are therefore important components of treatment.
Patients should provide their clinician with an accurate medical history, medication list and information about implanted devices or metal in or around the head before treatment.
How Effective Is Conventional TMS for Depression?
Conventional TMS is supported by randomized controlled trials, meta-analyses and clinical consensus recommendations.
A major updated consensus review on TMS for depression concluded that there is a robust evidence base supporting left-DLPFC TMS for Major Depressive Disorder, including treatment-resistant depression.
Clinical TMS Society recommendations similarly support TMS as an acute treatment option for appropriately selected patients with Major Depressive Disorder who have not received satisfactory benefit from antidepressant medication or who cannot tolerate medication.
However, treatment outcomes vary.
Some patients experience substantial improvement, some experience partial improvement, and others may not respond at all to TMS therapy.
For this reason, symptoms should be monitored throughout treatment using clinical assessment and, when appropriate, standardized measures of severity of your depression or OCD.
How fast does Conventional TMS work?
TMS does not usually work overnight. Some people begin to notice changes within the first few weeks of treatment, while others may need several weeks before experiencing meaningful improvement.
A typical course of conventional TMS involves treatment sessions 5 days a week for several weeks. Improvement can continue throughout the treatment course, so it’s important to complete the recommended sessions even if changes are gradual at first.
Everyone responds differently. Your treatment team will monitor your progress throughout the course and adjust your treatment plan when appropriate.
Our other treatment options
Neuromodulatory protocols are highly individualized based on your unique clinical context. Your Bridge specialist will precisely map and tailor a treatment plan optimized for your specific brain network and recovery goals.
Accelerated TMS
Theta-Burst Stimulation (TBS)
Deep TMS (dTMS)
SAINT TMS
Whatever else is part of your picture, there's a program for that too.
Insomnia Program
A medication-free option for perinatal depression.
TMS is among the most evidence- supported non-pharmacological options for patients who can't or won't use medication during pregnancy.
OCD Program
TMS is FDA-cleared for OCD.
For treatment-resistant OCD, TMS enters the plan as a coordinated recommendation from both Dr. Nattagh and Dr. Dickey — each with full clinical context.
Research Center
Where TMS protocol decisions come
from.
The same physician directing your TMS is tracking the outcomes. Protocol development and clinical decisions are one continuous process at Bridge.
Bridge Research Center
— 60 year old male with depression
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