rTMS in practice

Following the neuroCare approach neuroCare clinics offer personalized treatment with rTMS in combination with psychotherapy for the best possible outcome for patients suffering Depression or OCD. We understand rTMS is a relatively unknown treatment method, so we invite you to find out more about its success here.

Intake

A therapist will first conduct an intake interview and a QEEG assessment (analysis of brain activity) before any rTMS treatment.
During the interview we try to get the best possible picture of the patient's symptoms by conducting a structured diagnostic interview (Mini International Neuropsychiatric Interview) in which complaint areas are indicated according the criteria of the DSM-V (which is the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association)
 
The client is then asked to fill out self-report questionnaire and is asked to wear an 'Actiwatch’ in the period between intake and treatment.The 'Actiwatch’ is a watch that measures physical activity and sleep; two factors that play an important role in the onset and maintenance of depression. In addition to the results obtained through the questionnaire, the 'Actogram ' provides a more objective analysis regarding the patient's symptoms, leading to a better understanding for both patient and therapist. The patient will wear the 'Actiwatch' again to evaluate whether sleep or activity changes have occurred after treatment with rTMS.
 
The 'Actiwatch' worn before and after rTMS treatment

The QEEG assessment

In a comprehensive assessment, an EEG of 26 channels is recorded - we call this QEEG research. The collected data is compared to a database of healthy subjects. QEEG research is needed to be able to apply rTMS in a responsible way. We personalize the treatment based on the results of the assessment so that this will be more effective. It also examines whether rTMS can be applied safely. Read more about safety under the heading contraindications below.
 
The following video provides further information and background about the QEEG and intake procedures at neuroCare clinics:

Treatment

In the treatment of depression  and OCD with rTMS the patient sits in a comfortable chair with a figure-8 shaped coil above the head. This coil generates a pulsating magnetic field on which specific areas and networks in the brains are activated. The pulsating magnetic field is able to penetrate through the skull and can be heard as a tapping sound in the coil. You can feel these pulses but they are not painful. The feeling is much like if you were to tap a pencil
 
Because the pulses are highly magnetic, they are able to improve the communication between networks of certain areas of the brain. I most patients, this will decrease depressive symptoms.
 
A therapy session lasts 45 minutes and in this session rTMS will be applied for about 20 minutes. Remember, rTMS will be combined with psychotherapy to achieve the best possible outcome for the patient. After 10 sessions there should be a noticeable effect, and usually there are about 20 sessions required for lasting results (25 sessions in the treatment of OCD*).
 
The video below will show an overview of the rTMS treatment and associated procedures at neuroCare clinics: