Frequently Asked Questions
How confident should I be that fMRI guided Transcranial Magnet Stimulation can help?
TMS has been around for over 20 years. rTMS the most common type of TMS is delivered once a day for six weeks. fMRI-guided Theta Burst TMS is administered in 10-minute sessions, 10 times a day for one week. This new approach has been shown to almost double the efficacy of treatment. 79% of patients reported their depression in remission after treatment.
Why is the fMRI important for TMS treatment success?
For patients with depression or treatment-resistant depression, the target site is called the Dorsolateral Prefrontal Cortex (DLPFC). This site is found in rTMS therapy by finding the motor cortex and measuring down 5.5cm. This approach can lead to many different targets based on head size and shape which vary from patient to patient. The fMRI allows us to precisely target the DLPFC and ensure we place the coil in the right location every time.
Chen et al 2024
How is the Cognitive FX TMS protocol different from other TMS clinics?
There are two main differences: 1) We target the correct site with fMRI, and 2) We have a neuro-navigation device that ensures that we are right on target for every treatment session. Most clinics don't have these devices and use rule-of-thumb measurements to get the coil placed in the area they think is correct. This can lead to coil placement in less-than-optimal locations.
What is the TMS depression treatment like?
Treatment will last one week, 10 hours a day. The stimulation protocol will last about 12 minutes each hour, and then the remaining time will be used for cardio or rest. You will have your own private room to relax in during the rest period of treatment. TMS is a very safe protocol. Less than one in 10,000 treatments has an adverse outcome; the most commonly reported side effects are headache, scalp tenderness, and muscle twitching during treatment.
How do I know if treatment is right for me?
If you are dealing with symptoms of depression, TMS treatment could be right for you. If SSRIs haven't worked or you don't like the way you feel on medication, TMS could be a good option. As of now, fMRI-guided TMS has been shown to be the most effective treatment option for those dealing with depression.
How much does fMRI Guided TMS cost?
Pricing ranges from $7000 to $12000 depending on what other services you might need. Currently, insurance only covers the rTMS protocol, which lasts six weeks and is about 45% effective. Given the recent FDA clearance of fMRI-guided Theta Burst treatment, most insurance companies have yet to add it to the formularies they cover.