Transcranial magnetic stimulation (TMS) has been around for more than a decade, but this story encourages the reader to see the procedure as new by offering virtually no historical context. Additionally, it offers little in the way of systematic evidence for the technique’s efficacy, and includes several factual errors.
Clearly, many physicians embrace TMS, but a 2007 overview article in Nature offers what remains a salient cautionary note: “Although there is good evidence that this technique can modify cortical activity, the rationale for its use in many of the conditions investigated so far is not clear.”
Some 15 million adults wrestle with significant depression, and many migrate from one type of treatment to another in an ongoing search for relief. Quick, relatively painless applications of electromagnetic pulses to regions of the brain will be hard to resist, despite the uncertainties in outcome. News stories should not oversell the treatment or overlook the medical evidence for and against its use.
Cost is mentioned in the photo caption. And, the reader will find a cautionary comment lower in the story warning that “TMS is not widely covered by health insurance,” although other TMS stories indicate that insurance companies are slowly coming to the table.
The story only notes that studies employing TMS sessions to treat Parkinson’s and autism “have seen some success,” but the reader will find no specific information about what that means. Also missing: What percentage of patients with depression respond to treatment, and if the effects are short-term or long-term.
Side effects are a feature of this story.
The reader will find virtually no information about systematic studies of the efficacy of this technique. A 2012 study, not mentioned in this story, did find that the use of TMS in 42 clinics around the country to treat depression and anxiety yielded improvement in more than 50% of the 307 patients examined. But for many people, depressive symptoms return, leading some physicians to recommend “maintenance” TMS sessions every month or so, a process with as yet little systematic evidence to support it.
Those studying TMS acknowledge that much remains to be understood, from the most effective way to administer the technique to its long-term impacts.
Serious depression is a killer, and treatments are not consistently effective for many people. But the story misleads with its description of depression.
First, the story relates the old neurotransmitter deficit idea–specifically that of serotonin–which has largely been debunked.
We also take issue with the first line of the article: “One of the leading causes of disability in the United States isn’t physical—it’s mental.”
Mental illness is indeed physical, as the article even mentions when it discusses the “physical” brain changes later in the story.
The one scientist quoted in this story holds patents on several brain stimulation methods and apparatuses, a potential conflict of interest that receives no attention in the story.
The story briefly mentions other treatments, such as drugs and talk therapy.
It would have been a stronger effort if it had made an effort to compare success rates.
The story states “its use is federally restricted with exemptions only for those with severe depression.”
This is incorrect and a misinterpretation/misunderstanding of the FDA approved indication for depression. The FDA (the “federal” we assume here) approved TMS for the treatment of depression after a patient fails to respond to one antidepressant, whatever his or her’s degree of depression severity (moderate, severe…). A physician makes the judgement of whether TMS is indicated and can do so even before trying a drug if there is some reason a person cannot tolerate drugs. The FDA does not regulate the practice of medicine.
TMS has indeed been around for decades now, 1985 according to the NIMH web site.
While a news release does not seem to be at the base of this story, the text seems to have stemmed in part from another journalistic effort: an NPR story in 2016. That suggests only modest enterprise work here.