Transcranial magnetic stimulation: Difference between revisions

{{Short description|Form of brainBrain stimulation using magnetic fields}}

TMS has shown diagnostic and therapeutic potential in the [[central nervous system]] with a wide variety of disease states in [[neurology]] and [[mental health]], with research still evolving.<ref name=diagnostic1>{{cite journal | vauthors = Groppa S, Oliviero A, Eisen A, Quartarone A, Cohen LG, Mall V, Kaelin-Lang A, Mima T, Rossi S, Thickbroom GW, Rossini PM, Ziemann U, Valls-Solé J, Siebner HR | display-authors = 6 | title = A practical guide to diagnostic transcranial magnetic stimulation: report of an IFCN committee | journal = Clinical Neurophysiology | volume = 123 | issue = 5 | pages = 858–882 | date = May 2012 | pmid = 22349304 | pmc = 4890546 | doi = 10.1016/j.clinph.2012.01.010 }}</ref><ref name=Lefaucher1>{{cite journal | vauthors = Lefaucheur JP, André-Obadia N, Antal A, Ayache SS, Baeken C, Benninger DH, Cantello RM, Cincotta M, de Carvalho M, De Ridder D, Devanne H, Di Lazzaro V, Filipović SR, Hummel FC, Jääskeläinen SK, Kimiskidis VK, Koch G, Langguth B, Nyffeler T, Oliviero A, Padberg F, Poulet E, Rossi S, Rossini PM, Rothwell JC, Schönfeldt-Lecuona C, Siebner HR, Slotema CW, Stagg CJ, Valls-Sole J, Ziemann U, Paulus W, Garcia-Larrea L | display-authors = 6 | title = Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS) | journal = Clinical Neurophysiology | volume = 125 | issue = 11 | pages = 2150–2206 | date = November 2014 | pmid = 25034472 | doi = 10.1016/j.clinph.2014.05.021 | s2cid = 206798663 | url = https://hal.archives-ouvertes.fr/hal-03183867/file/S1388245719312799.pdf }}</ref><ref name=pmid21474597>{{cite journal |last1=George |first1=Mark S. |last2=Post |first2=Robert M. |title=Daily Left Prefrontal Repetitive Transcranial Magnetic Stimulation for Acute Treatment of Medication-Resistant Depression |journal=American Journal of Psychiatry |date=April 2011 |volume=168 |issue=4 |pages=356–364 |doi=10.1176/appi.ajp.2010.10060864 |pmid=21474597 }}</ref><ref name=pmid22091472>{{cite book |last1=Gaynes |first1=Bradley N. |last2=Lux |first2=Linda J. |last3=Lloyd |first3=Stacey W. |last4=Hansen |first4=Richard A. |last5=Gartlehner |first5=Gerald |last6=Keener |first6=Patricia |last7=Brode |first7=Shannon |last8=Evans |first8=Tammeka Swinson |last9=Jonas |first9=Dan |last10=Crotty |first10=Karen |last11=Viswanathan |first11=Meera |last12=Lohr |first12=Kathleen N. |title=Nonpharmacologic Interventions for Treatment-Resistant Depression in Adults |date=2011 |pmid=22091472 |url=https://www.ncbi.nlm.nih.gov/books/NBK65315/ |publisher=Agency for Healthcare Research and Quality |series=AHRQ Comparative Effectiveness Reviews }}</ref><ref name=pmid23249815>{{cite journal |last1=Berlim |first1=Marcelo T |last2=Van den Eynde |first2=Frederique |last3=Jeff Daskalakis |first3=Z |title=Clinically Meaningful Efficacy and Acceptability of Low-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) for Treating Primary Major Depression: A Meta-Analysis of Randomized, Double-Blind and Sham-Controlled Trials |journal=Neuropsychopharmacology |date=19 November 2012 |volume=38 |issue=4 |pages=543–551 |doi=10.1038/npp.2012.237 |pmid=23249815 |pmc=3572468 }}</ref><ref name="Perera et al 2015">{{cite report |first1=Tarique |last1=Perera |first2=Mark |last2=George |first3=Geoffrey |last3=Grammer |first4=Philip |last4=Janicak |first5=Alvaro |last5=Pascual-Leone |first6=Theodore |last6=Wirecki |date=April 27, 2015 |title=TMS Therapy For Major Depressive Disorder: Evidence Review and Treatment Recommendations for Clinical Practice |url=http://tmscenterofcolorado.com/wp-content/uploads/2015/09/Clinical-TMS-Society-WhitePaper_2015.pdf }}</ref><ref name=pmid22559998>{{cite journal |last1=Bersani |first1=F.S. |last2=Minichino |first2=A. |last3=Enticott |first3=P.G. |last4=Mazzarini |first4=L. |last5=Khan |first5=N. |last6=Antonacci |first6=G. |last7=Raccah |first7=R.N. |last8=Salviati |first8=M. |last9=Delle Chiaie |first9=R. |last10=Bersani |first10=G. |last11=Fitzgerald |first11=P.B. |last12=Biondi |first12=M. |title=Deep transcranial magnetic stimulation as a treatment for psychiatric disorders: A comprehensive review |journal=European Psychiatry |date=January 2013 |volume=28 |issue=1 |pages=30–39 |doi=10.1016/j.eurpsy.2012.02.006 |pmid=22559998 |s2cid=29053871 }}</ref><ref name=Doug2015>{{cite journal | vauthors = Dougall N, Maayan N, Soares-Weiser K, McDermott LM, McIntosh A | title = Transcranial magnetic stimulation (TMS) for schizophrenia | journal = The Cochrane Database of Systematic Reviews | volume = 2015 | issue = 8 | pages = CD006081 | date = August 2015 | pmid = 26289586 | doi = 10.1002/14651858.CD006081.pub2 | pmc = 9395125 | url = http://dspace.stir.ac.uk/bitstream/1893/22520/1/Dougall_et_al-2015-The_Cochrane_Library.pdf | hdl = 1893/22520 | hdl-access = free }}</ref><ref>{{Cite web |title=Pupil response may shed light on who responds best to transcranial magnetic stimulation for depression |url=https://www.uclahealth.org/news/pupil-response-may-shed-light-who-responds-best-transcranial |access-date=2024-01-06 |website=www.uclahealth.org |language=en}}</ref>

TMS can be used clinically to measure activity and function of specific brain circuits in humans, most commonly with single or paired magnetic pulses.<ref name=diagnostic1 /> The most widely accepted use is in measuring the connection between the [[primary motor cortex]] of the [[central nervous system]] and the [[peripheral nervous system]] to evaluate damage related to past or progressive neurologic insult.<ref name=diagnostic1 /><ref>{{cite journal | vauthors = Rossini PM, Rossi S | title = Transcranial magnetic stimulation: diagnostic, therapeutic, and research potential | journal = Neurology | volume = 68 | issue = 7 | pages = 484–488 | date = February 2007 | pmid = 17296913 | doi = 10.1212/01.wnl.0000250268.13789.b2 | s2cid = 19629888 }}</ref><ref name="Dimyan">{{cite journal | vauthors = Dimyan MA, Cohen LG | title = Contribution of transcranial magnetic stimulation to the understanding of functional recovery mechanisms after stroke | journal = Neurorehabilitation and Neural Repair | volume = 24 | issue = 2 | pages = 125–135 | date = February 2010 | pmid = 19767591 | pmc = 2945387 | doi = 10.1177/1545968309345270 }}</ref><ref name="Nowak">{{cite journal | vauthors = Nowak DA, Bösl K, Podubeckà J, Carey JR | title = Noninvasive brain stimulation and motor recovery after stroke | journal = Restorative Neurology and Neuroscience | volume = 28 | issue = 4 | pages = 531–544 | year = 2010 | pmid = 20714076 | doi = 10.3233/RNN-2010-0552 }}</ref> TMS has utility as a diagnostic instrument for [[myelopathy]], [[amyotrophic lateral sclerosis]], and [[multiple sclerosis]].<ref name="Chen2008">{{cite journal |last1=Chen |first1=Robert |last2=Cros |first2=Didier |last3=Curra |first3=Antonio |last4=Di Lazzaro |first4=Vincenzo |last5=Lefaucheur |first5=Jean-Pascal |last6=Magistris |first6=Michel R. |last7=Mills |first7=Kerry |last8=Rösler |first8=Kai M. |last9=Triggs |first9=William J. |last10=Ugawa |first10=Yoshikazu |last11=Ziemann |first11=Ulf |title=The clinical diagnostic utility of transcranial magnetic stimulation: Report of an IFCN committee |journal=Clinical Neurophysiology |date=March 2008 |volume=119 |issue=3 |pages=504–532 |doi=10.1016/j.clinph.2007.10.014}}</ref>

Transcranial magnetic stimulation is achieved by quickly discharging current from a large [[capacitor]] into a coil to produce pulsed [[magnetic fields]] between 2 and 3 [[Tesla (unit)|Teslateslas]] in strength.<ref name=Walsh>V. Walsh and A. Pascual-Leone, "Transcranial Magnetic Stimulation: A Neurochronometrics of Mind." Cambridge, Massachusetts: MIT Press, 2003.</ref> Directing the magnetic field pulse at a targeted area in the brain causes a localized electrical current which can then either [[depolarization|depolarize]] or [[hyperpolarization (biology)|hyperpolarize]] neurons at that site.

TMS usually stimulates to a depth from 2 to 4&nbsp;cm below the surface, depending on the coil and intensity used. Consequently, only superficial brain areas can be affected.<ref>{{Cite journal |last=Lefaucheur |first=Jean-Pascal |last2=André-Obadia |first2=Nathalie |last3=Antal |first3=Andrea |last4=Ayache |first4=Samar S. |last5=Baeken |first5=Chris |last6=Benninger |first6=David H. |last7=Cantello |first7=Roberto M. |last8=Cincotta |first8=Massimo |last9=de Carvalho |first9=Mamede |last10=De Ridder |first10=Dirk |last11=Devanne |first11=Hervé |last12=Di Lazzaro |first12=Vincenzo |last13=Filipović |first13=Saša R. |last14=Hummel |first14=Friedhelm C. |last15=Jääskeläinen |first15=Satu K. |date=November 2014 |title=Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS) |url=https://linkinghub.elsevier.com/retrieve/pii/S138824571400296X |journal=Clinical Neurophysiology |language=en |volume=125 |issue=11 |pages=2150–2206 |doi=10.1016/j.clinph.2014.05.021}}</ref> Deep TMS can reach up to 6&nbsp;cm into the brain to stimulate deeper layers of the [[motor cortex]], such as that which controls leg motion. The path of this current can be difficult to model because the brain is irregularly shaped with variable internal density and water content, leading to a nonuniform magnetic field strength and [[Electrical conduction|conduction]] throughout its tissues.<ref>See:

* Repetitive TMS produces longer-lasting effects which persist past the period of stimulation. rTMS can increase or decrease the excitability of the [[corticospinal tract]] depending on the intensity of stimulation, coil orientation, and frequency. Low frequency rTMS with a stimulus frequency less than 1&nbsp;Hz is believed to inhibit cortical firing while a stimulus frequency greater than 1&nbsp;Hz, or high frequency, is believed to provoke it.<ref name="ReferenceA">{{cite journal | vauthors = Cusin C, Dougherty DD | title = Somatic therapies for treatment-resistant depression: ECT, TMS, VNS, DBS | journal = Biology of Mood & Anxiety Disorders | volume = 2 | issue = 1 | pages = 14 | date = August 2012 | pmid = 22901565 | pmc = 3514332 | doi = 10.1186/2045-5380-2-14 | doi-access = free }}</ref> Though its mechanism is not clear, it has been suggested as being due to a change in synaptic efficacy related to [[long-term potentiation]] (LTP) and long-term depression like plasticity (LTD-like plasticity).<ref name=Fitzgerald>{{cite journal | vauthors = Fitzgerald PB, Fountain S, Daskalakis ZJ | title = A comprehensive review of the effects of rTMS on motor cortical excitability and inhibition | journal = Clinical Neurophysiology | volume = 117 | issue = 12 | pages = 2584–2596 | date = December 2006 | pmid = 16890483 | doi = 10.1016/j.clinph.2006.06.712 | s2cid = 31458874 }} </ref><ref>Baur D, Galevska D, Hussain S, Cohen LG, Ziemann U, Zrenner C. Induction of LTD-like corticospinal plasticity by low-frequency rTMS depends on pre-stimulus phase of sensorimotor μ-rhythm. Brain Stimul. 2020 Nov-Dec;13(6):1580-1587. doi: 10.1016/j.brs.2020.09.005. Epub 2020 Sep 17. PMID: 32949780; PMCID: PMC7710977.</ref>

In 1980 Merton and Morton successfully used transcranial electrical stimulation (TES) to stimulate the motor cortex. However, this process was very uncomfortable, and subsequently Anthony T. Barker began to search for an alternative to TES.<ref>{{cite journal | vauthors = Klomjai W, Katz R, Lackmy-Vallée A | title = Basic principles of transcranial magnetic stimulation (TMS) and repetitive TMS (rTMS) | journal = Annals of Physical and Rehabilitation Medicine | volume = 58 | issue = 4 | pages = 208–213 | date = September 2015 | pmid = 26319963 | doi = 10.1016/j.rehab.2015.05.005 | doi-access = free }}</ref> He began exploring the use of magnetic fields to alter electrical signaling within the brain, and the first stable TMS devices were developed in 1985.<ref name=Horvath/><ref name=Nooh/> They were originally intended{{by whom|date=October 2019}} as diagnostic and research devices, with evaluation of their therapeutic potential being a later development.<ref name=Horvath/><ref name=Nooh/> The United States' [[Food and Drug Administration|FDA]] first approved TMS devices in October 2008.<ref name=Horvath/>

With [[Parkinson's disease]], early results suggest that low frequency stimulation may have an effect on medication associated [[dyskinesia]], and that high frequency stimulation improves motor function.<ref>{{cite journal | vauthors = Machado S, Bittencourt J, Minc D, Portella CE, Velasques B, Cunha M, Budde H, Basile LF, Chadi G, Cagy M, Piedade R, Riberio P | display-authors = 6 | title = Therapeutic applications of repetitive transcranial magnetic stimulation in clinical neurorehabilitation | journal = Functional Neurology | volume = 23 | issue = 3 | pages = 113–122 | date = 2008 | pmid = 19152730 }}</ref><ref>{{Cite journal |last1=Liu |first1=Xuan |last2=Li |first2=Lei |last3=Liu |first3=Ye |date=2023-09-29 |title=Comparative motor effectiveness of non-invasive brain stimulation techniques in patients with Parkinson's disease: A network meta-analysis |journal=Medicine |volume=102 |issue=39 |pages=e34960 |doi=10.1097/MD.0000000000034960 |issn=1536-5964 |pmid=37773851|pmc=10545289 }}</ref> The most effective treatment protocols appear to involve high frequency stimulation of the [[motor cortex]], particularly on the dominant side,<ref name="Chou YH 2014">{{cite journal | vauthors = Chou YH, Hickey PT, Sundman M, Song AW, Chen NK | title = Effects of repetitive transcranial magnetic stimulation on motor symptoms in Parkinson disease: a systematic review and meta-analysis | journal = JAMA Neurology | volume = 72 | issue = 4 | pages = 432–440 | date = April 2015 | pmid = 25686212 | pmc = 4425190 | doi = 10.1001/jamaneurol.2014.4380 }}</ref> but with more variable results for treatment of the [[dorsolateral prefrontal cortex]].<ref>{{cite journal | vauthors = Yang C, Guo Z, Peng H, Xing G, Chen H, McClure MA, He B, He L, Du F, Xiong L, Mu Q | display-authors = 6 | title = Repetitive transcranial magnetic stimulation therapy for motor recovery in Parkinson's disease: A Meta-analysis | journal = Brain and Behavior | volume = 8 | issue = 11 | page = e01132 | date = November 2018 | pmid = 30264518 | pmc = 6236247 | doi = 10.1002/brb3.1132 }}</ref> It is less effective than [[electroconvulsive therapy]] for motor symptoms, though both appear to have utility.<ref>{{cite journal | vauthors = Fregni F, Simon DK, Wu A, Pascual-Leone A | title = Non-invasive brain stimulation for Parkinson's disease: a systematic review and meta-analysis of the literature | journal = Journal of Neurology, Neurosurgery, and Psychiatry | volume = 76 | issue = 12 | pages = 1614–1623 | date = December 2005 | pmid = 16291882 | pmc = 1739437 | doi = 10.1136/jnnp.2005.069849 }}</ref><ref>{{cite journal | vauthors = Lefaucheur JP | title = Treatment of Parkinson's disease by cortical stimulation | journal = Expert Review of Neurotherapeutics | volume = 9 | issue = 12 | pages = 1755–1771 | date = December 2009 | pmid = 19951135 | doi = 10.1586/ern.09.132 | s2cid = 6404434 }}</ref><ref>{{cite journal | vauthors = Arias-Carrión O | title = Basic mechanisms of rTMS: Implications in Parkinson's disease | journal = International Archives of Medicine | volume = 1 | issue = 1 | page = 2 | date = April 2008 | pmid = 18471317 | pmc = 2375865 | doi = 10.1186/1755-7682-1-2 | doi-access = free }}</ref> Cerebellar stimulation has also shown potential for the treatment of levodopa associated dyskinesia.<ref>{{cite journal | vauthors = França C, de Andrade DC, Teixeira MJ, Galhardoni R, Silva V, Barbosa ER, Cury RG | title = Effects of cerebellar neuromodulation in movement disorders: A&nbsp;systematic review | journal = Brain Stimulation | volume = 11 | issue = 2 | pages = 249–260 | pmid = 29191439 | doi = 10.1016/j.brs.2017.11.015 | year = 2018 | s2cid = 46810543 }}</ref>

A study on alternative Alzheimer's treatments at the Wahrendorff Clinic in Germany in 2021<ref>{{Cite web |date=11 April 2023 |year=2023 |title=Alternative Alzheimer's Treatments Offering Hope - 84% of the subjects surveyed rated their psychological well-being after the TPS treatment as medium to good |url=https://hitoshin.com/blog/alternative-alzheimers-treatments-offering-hope/ |website=Hitoshin}}</ref> reported that 84% of participants in the study have experienced positive effects after using the treatment.

Under the supervision of Professor Marc Ziegenbein, a psychiatry and psychotherapy specialist, the study of 77 subjects with mild to moderate Alzheimer’sAlzheimer's disease received frequent transcranial magnetic stimulation applications and observed over a period of time.

Mimicking the physical discomfort of TMS with [[placebo]] to discern its true effect is a challenging issue in research.<ref name=Lefaucher1 /><ref name=Rossi /><ref name=Duecker>{{cite journal | vauthors = Duecker F, Sack AT | title = Rethinking the role of sham TMS | journal = Frontiers in Psychology | volume = 6 | page= 210 | year = 2015 | pmid = 25767458 | pmc = 4341423 | doi = 10.3389/fpsyg.2015.00210 | doi-access = free }}</ref><ref name = Davis>{{cite journal | vauthors = Davis NJ, Gold E, Pascual-Leone A, Bracewell RM | title = Challenges of proper placebo control for non-invasive brain stimulation in clinical and experimental applications | journal = The European Journal of Neuroscience | volume = 38 | issue = 7 | pages = 2973–2977 | date = October 2013 | pmid = 23869660 | doi = 10.1111/ejn.12307 | s2cid = 2152097 | url = https://zenodo.org/record/3436292 }}</ref> It is difficult to establish a convincing [[placebo]] for TMS during [[Scientific control|controlled]] [[Clinical trial|trials]] in [[conscious]] individuals due to the neck pain, headache and twitching in the scalp or upper face associated with the intervention.<ref name=Lefaucher1 /><ref name = Rossi /> In addition, placebo manipulations can affect [[cerebrum|brain]] [[Glycolysis|sugar metabolism]] and MEPs, which may confound results.<ref name="pmid17655558">{{cite journal | vauthors = Marangell LB, Martinez M, Jurdi RA, Zboyan H | title = Neurostimulation therapies in depression: a review of new modalities | journal = Acta Psychiatrica Scandinavica | volume = 116 | issue = 3 | pages = 174–181 | date = September 2007 | pmid = 17655558 | doi = 10.1111/j.1600-0447.2007.01033.x | s2cid = 38081703 }}</ref> This problem is exacerbated when using [[Subjectivity|subjective]] measures of improvement.<ref name = Rossi /> Placebo responses in trials of rTMS in major depression are [[Negative relationship|negatively associated]] with refractoriness to treatment.<ref>{{cite journal | vauthors = Brunoni AR, Lopes M, Kaptchuk TJ, Fregni F | title = Placebo response of non-pharmacological and pharmacological trials in major depression: a systematic review and meta-analysis | journal = PLOS ONE | volume = 4 | issue = 3 | page= e4824 | year = 2009 | pmid = 19293925 | pmc = 2653635 | doi = 10.1371/journal.pone.0004824 | bibcode = 2009PLoSO...4.4824B | doi-access = free }}</ref>

The National Institutes of Health estimates depression medications work for 60 percent to 70 percent of people who take them.<ref>{{cite book | url=https://www.ncbi.nlm.nih.gov/books/NBK20369/|title= Information about Mental Illness and the Brain|year= 2007|publisher= National Institutes of Health (US)}}</ref><ref> In addition, the World Health Organization reports that the number of people living with depression has increased nearly 20 percent since 2005.</ref> ItTMS is approved as a Class II medical device under the "''de novo'' pathway".<ref>Michael Drues, for Med Device Online. 5 February 2014 [http://www.meddeviceonline.com/doc/secrets-of-the-de-novo-pathway-part-why-aren-t-more-device-makers-using-it-0001 Secrets Of The De Novo Pathway, Part 1: Why Aren't More Device Makers Using It?]</ref><ref name=2015revPain>{{cite journal | vauthors = Schwedt TJ, Vargas B | title = Neurostimulation for Treatment of Migraine and Cluster Headache | journal = Pain Medicine | volume = 16 | issue = 9 | pages = 1827–1834 | date = September 2015 | pmid = 26177612 | pmc = 4572909 | doi = 10.1111/pme.12792 }}</ref> In addition, the World Health Organization reports that the number of people living with depression has increased nearly 20 percent since 2005.<ref>{{Cite web |title="Depression: let's talk" says WHO, as depression tops list of causes of ill health |url=https://www.who.int/news/item/30-03-2017--depression-let-s-talk-says-who-as-depression-tops-list-of-causes-of-ill-health |access-date=2022-08-10 |website=www.who.int |language=en}}</ref> In a 2012 study, TMS was found to improve depression significantly in 58 percent of patients and provide complete remission of symptoms in 37 percent of patients.<ref>{{cite journal |vauthors=Carpenter LL, Janicak PG, Aaronson ST, Boyadjis T, Brock DG, Cook IA, Dunner DL, Lanocha K, Solvason HB, Demitrack MA |title=Transcranial magnetic stimulation (TMS) for major depression: a multisite, naturalistic, observational study of acute treatment outcomes in clinical practice |journal=Depress Anxiety |volume=29 |issue=7 |pages=587–96 |date=July 2012 |pmid=22689344 |doi=10.1002/da.21969 |s2cid=22968810 |url=}}</ref> In 2002, Cochrane Library reviewed randomized controlled trials using TMS to treat depression. The review did not find a difference between rTMS and sham TMS, except for a period 2 weeks after treatment.<ref>{{cite journal |last1=Rodriguez-Martin |first1=José Luis |last2=Barbanoj |first2=José Manuel |last3=Schlaepfer |first3=Te |last4=Clos |first4=Susana SC |last5=Pérez |first5=V |last6=Kulisevsky |first6=J |last7=Gironell |first7=A |title=Transcranial magnetic stimulation for treating depression |journal=Cochrane Database of Systematic Reviews |date=22 April 2002 |volume=2018 |issue=11 |pages=CD003493 |doi=10.1002/14651858.CD003493 |pmid=12076483 |url=https://www.cochrane.org/CD003493/DEPRESSN_transcranial-magnetic-stimulation-tms-depression |access-date=11 December 2023 |language=en|pmc=6516872 }}</ref> In 2018, Cochrane Library stated a plan to contact authors about updating the review of rTMS for depression.<ref>{{cite webjournal |last1=Hendon |first1=Jessica |title=Transcranial magnetic stimulation for treating depression |url=https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003493/detailed-comment/en?messageId=412823984 |websitejournal=Cochrane Database of Systematic Reviews |access-date=11 December 2023 |language=en |doi=10.1002/14651858.cd003493/detailed-comment/en?messageid=412823984CD003493 |date=2002|volume=2018 |issue=11 |pages=CD003493 |pmid=12076483 |pmc=6516872 }}</ref>

In 2020, US FDA authorized the use of TMS developed by the U.S. company MagVenture Inc. in the treatment of OCD.<ref>{{Cite web |title=MagVenture receives FDA clearance for OCD {{!}} Clinical TMS Society |url=https://www.clinicaltmssociety.org/news/2020-08/magventure-receives-fda-clearance-ocd-0 |access-date=2023-10-11 |website=www.clinicaltmssociety.org}}</ref>

In 2023, US FDA authorized the use of TMS developed by the U.S. company Neuronetics Inc. in the treatment of OCD.<ref>{{Cite web |title=FDA clears OCD motor threshold cap for transcranial magnetic stimulation system |url=https://www.healio.com/news/neurology/20230613/fda-clears-ocd-motor-threshold-cap-for-transcranial-magnetic-stimulation-system |access-date=2023-10-11 |website=www.healio.com |language=en}}</ref>

* In early 2012 in [[New England]], Medicare covered TMS for the first time in the United States.<ref>{{cite web|author=NHIC, Corp.|url=http://coverage.cms.fu.com/mcd_archive/viewlcd.asp?lcd_id=32228&lcd_version=5&basket=lcd%3A32228%3A5%3ARepetitive+Transcranial+Magnetic+Stimulation+%28rTMS%29%3AMAC+%2D+Part+B%3ANHIC%7C%7C+Corp%2E+%2814202%29%3A|archive-url=https://archive.today/2014.02.17-15273420140217152734/http://coverage.cms.fu.com/mcd_archive/viewlcd.asp?lcd_id=32228&lcd_version=5&basket=lcd:32228:5:Repetitive+Transcranial+Magnetic+Stimulation+(rTMS):MAC+-+Part+B:NHIC%7C%7C+Corp.+(14202):|url-status=dead|archive-date=2014-02-17|title=Local Coverage Determination (LCD) for Repetitive Transcranial Magnetic Stimulation (rTMS) (L32228)|publisher=[[Centers for Medicare and Medicaid Services]]|date=2013-10-24|access-date=2014-02-17}}</ref><ref>{{cite web|archive-url=https://web.archive.org/web/20130405070836/http://www.pbn.com/Important-Treatment-Option-for-Depression-Receives-Medicare-Coverage,66462|archive-date=2013-04-05|access-date=2012-10-11|url=http://www.pbn.com/Important-Treatment-Option-for-Depression-Receives-Medicare-Coverage,66462|title=Important Treatment Option for Depression Receives Medicare Coverage|work=Press Release|date=2012-03-30|publisher=PBN.com: Providence Business News|url-status=dead}}</ref><ref>{{cite web|author=The Institute for Clinical and Economic Review|date=June 2012|archive-url=https://web.archive.org/web/20131213211022/http://cepac.icer-review.org/wp-content/uploads/2012/07/rTMS-Coverage-Policy-Analysis.pdf|archive-date=2013-12-13|url=http://cepac.icer-review.org/wp-content/uploads/2012/07/rTMS-Coverage-Policy-Analysis.pdf|title=Coverage Policy Analysis: Repetitive Transcranial Magnetic Stimulation (rTMS)|publisher=The New England Comparative Effectiveness Public Advisory Council (CEPAC)|access-date=2013-12-11|url-status=dead}}</ref><ref>{{cite web|archive-url=https://web.archive.org/web/20120325091400/http://www.cvmc.org/news/2012-theresa-fama-cepac|archive-date=2012-03-25|url=http://www.cvmc.org/news/2012-theresa-fama-cepac|title=Transcranial Magnetic Stimulation Cites Influence of New England Comparative Effectiveness Public Advisory Council (CEPAC)|date=2012-02-06|location=[[Berlin, Vermont]]|publisher=[[Central Vermont Medical Center]]|access-date=2012-10-12|url-status=dead}}</ref> However, that jurisdiction later decided to end coverage after October, 2013.<ref>{{cite web|author=National Government Services, Inc. |url=http://www.cms.gov/medicare-coverage-database/details/lcd-details.aspx?LCDId=32038&ContrId=178&&bc=IAAAABAAAAAAAA%3d%3d&|date=2013-10-25|title=Local Coverage Determination (LCD): Transcranial Magnetic Stimulation (L32038)|publisher= [[Centers for Medicare and Medicaid Services]] |access-date=2014-02-17}}</ref>

* In August 2012, the jurisdiction covering Arkansas, Louisiana, Mississippi, Colorado, Texas, Oklahoma, and New Mexico determined that there was insufficient evidence to cover the treatment,<ref>{{cite web |urlauthor=http://wwwNovitas Solutions, Inc.cms.gov/medicare |date=2013-coverage12-database/details/lcd-details.aspx?LCDId=32752&ContrId=259&ver=15&ContrVer=1&DocID=L32752&SearchType=Advanced&bc=IAAAAAgAAAAAAA%3d%3d&l04 |title=LCD L32752 – Transcranial Magnetic Stimulation for Depression |authorurl=Novitashttps://hwscenter.com/treatments/#neuropsychology Solutions,|access-date=2014-02-17 Inc.|work=Contractor's Determination Number L32752|date=2013-12-04 |publisher=[[Centers for Medicare and Medicaid Services]]|access-date=2014-02-17}}</ref> but the same jurisdiction subsequently determined that Medicare would cover TMS for the treatment of depression after December 2013.<ref>{{cite web|url=http://www.cms.gov/medicare-coverage-database/details/lcd-details.aspx?LCDId=33660&ContrId=259&bc=IAAAAAgAAAAAAA%3d%3d&|title=LCD L33660 – Transcranial Magnetic Stimulation (TMS) for the Treatment of Depression|author=Novitas Solutions, Inc.|work=Contractor's Determination Number L33660|publisher= [[Centers for Medicare and Medicaid Services]]|date=2013-12-05|access-date=2014-02-17}}</ref>