Practice Statement

Dr. Cohen’s practice offers comprehensive treatment for mood and anxiety disorders. In addition to psychopharmacology and psychotherapy, Dr. Cohen’s office offers Transcranial Magnetic Stimulation (TMS), a medication-free alternative treatment for depression and other disorders; Ketamine, a cutting-edge psycho-pharmacological approach to depression; and pharmaco-genetic testing to help guide the approach to medication. 

TMS Therapy Uses

Transcranial magnetic stimulation (TMS) therapy uses a pulsing magnetic field to stimulate neurons in the brain. TMS has FDA clearance for the treatment of Major Depressive Disorder in those aged 18 and older. When thinking about the pros and cons of TMS therapy, you may also want to consider its potential uses. Research suggests that it could also treat additional mental and physical health conditions.

Why Is TMS Effective?

TMS therapy stimulates brain activity to reverse the brain hypoactivity associated with depression. Research indicates that depression reduces activity in the brain’s dorsolateral prefrontal cortex (DLPFC) — TMS helps restore this activity. By stimulating this part of the brain, TMS relieves depression symptoms.

According to research, TMS may also treat a variety of health conditions through this approach. The DLPFC manages functions such as motivation, working memory and cognitive control. It also modulates areas of the brain like the cingulate cortex, hippocampus and amygdala. Restoring brain activity in the DLPFC could impact any of these related functions and areas of the brain. Outside of the United States, some countries have government approval for the use of TMS for conditions such as post-traumatic stress disorder (PTSD).

TMS Therapy for Depression

For patients with depression, TMS can work as a supplement to other treatments or an alternative to medication. According to clinical trials, about 65% of patients with medication-resistant depression find improvement after TMS application. Nearly one-third of the people who report results have full symptom relief. Patients who experience this remission may need to receive TMS about every year for their symptom relief to continue.

TMS for Obsessive Compulsive Disorder (OCD)

Many studies support use of TMS for treatment of OCD, thought his remains an off-label treatment. By targeting the areas of the brain related to OCD symptoms, TMS can improve symptoms as much as OCD medication. Studies show that patients can experience ongoing relief after they stop receiving TMS. TMS may work to relieve OCD symptoms in patients when they don’t respond to first- or second-line treatments.

Post Traumatic Stress Disorder (PTSD) and TMS

Research suggests that a type of TMS therapy called intermittent theta-burst stimulation (iTBS) could reduce PTSD symptoms. This treatment shows promise for relieving PTSD-related depression and improving function in everyday life. Certain types of TMS therapy have government approval for PTSD treatment in Brazil and Europe. Smaller studies support the use of currently available TMS to treat PTSD as an off label treatment.

TMS Therapy for Anxiety

Low-frequency TMS treatment may help with the symptoms of generalized anxiety disorder (GAD). By sending slow pulses to the right side of the brain, TMS could promote an increase of inhibitory signals sent to the left side. Studies show that this approach can reduce the effects of GAD long-term. In this research, patients showed continuing improvement months after they received TMS therapy.

Bipolar Disorder and TMS

Bipolar depression has a similar source to major depression (also known as unipolar depression), making it a potential candidate for TMS. Research suggests that TMS can treat bipolar depression using a similar approach to TMS depression treatment. TMS therapy for bipolar-related mania does not have as much research, but your Principium doctor can help you find a combined solution.

Treating Alzheimer’s Disease With TMS

Neuroscientists are currently exploring TMS therapy’s potential as a treatment for Alzheimer’s disease. They will need to show more results before TMS can receive FDA approval as an Alzheimer’s disease treatment. If TMS does show positive results in the future, it will provide a new option for this difficult-to-treat disorder.

Hoarding Disorder and TMS Treatment

A case study suggests that TMS could improve decision making in patients with hoarding disorder. The DLPFC influences parts of the brain related to value-based decision making. As a result, TMS that stimulates the DLPFC could help people with hoarding disorder make item-related decisions.

TMS for Autism

Treatment with TMS could improve the excitatory/inhibitory imbalance in the brain that causes autism spectrum disorder (ASD) symptoms. ASD has many potential TMS targets in the brain that affect its inhibition and excitation functions. In other words, TMS may help patients with ASD balance the firing of signals in their brain for symptom relief.

Stroke and TMS Therapy

Stroke-related brain disorders may also respond to TMS therapy. Right now, neuroscientists mainly use TMS to understand how the brain recovers after a stroke limits someone’s mobility. In the future, TMS could have use in stimulating this recovery.

TMS Therapy for Migraines and Chronic Pain

In addition to treating mental health conditions and brain disorders, TMS could also treat physical conditions such as migraines and chronic pain. A TMS therapy called single-pulse transcranial magnetic stimulation (sTMS) shows promise in studies on patients with migraines. Meanwhile, repetitive TMS (rTMS) may also reduce the severity of chronic pain.

Attention Deficit Hyperactivity Disorder (ADHD) and TMS

Preliminary research on ADHD and TMS treatment show that TMS therapy could relieve the focus issues associated with ADHD. However, additional studies are needed before neuroscientists can make any conclusions on the treatment’s effectiveness for ADHD. Studies indicate TMS can improve working memory and cognition.

Reasons to Choose Principium Psychiatry for TMS Treatment

Our patients choose to receive TMS therapy at Principium because of our:

  • Innovative approaches: At Principium, we provide state-of-the-art treatments such as TMS and ketamine therapy. We select the services we offer based on scientific evidence.
  • Team of experts: Our staff includes experienced professionals that specialize in a wide range of treatments and conditions. They work with leading universities and medical centers across the country.
  • Convenient and beautiful location: You can find the Principium office near Columbus Circle, one of Manhattan’s most beautiful areas. This convenient location is close to multiple subway lines for easy access. Our newest office is located along Wall Street in Lower Manhattan! This offers convenient access to finance professionals and residents in Lower Manhattan, Brooklyn and Jersey City.

*Patient names have been changed in order to preserve privacy.