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Deep Transcranial Magnetic Stimulation (dTMS)

Deep Transcranial Magnetic Stimulation (dTMS)

Deep transcranial magnetic stimulation (dTMS) is a non-invasive form of repetitive transcranial magnetic stimulation (rTMS). It may be considered for some people with obsessive-compulsive disorder (OCD) or major depressive disorder (MDD), particularly when previous treatments have not provided satisfactory improvement. At Monarch Mental Health Group (MMHG), suitability and treatment planning are assessed individually.

What Is Deep Transcranial Magnetic Stimulation?

dTMS delivers repeated magnetic pulses through a specialised coil positioned over the scalp. These pulses stimulate selected networks in the cerebral cortex. H-coil systems are designed to stimulate broader and deeper cortical areas than conventional figure-eight coils while remaining non-invasive.

Treatment is performed while the patient is awake and seated. It does not involve surgery, anaesthesia or an implanted device.

How Are dTMS and iTBS Different?

Deep TMS and intermittent theta-burst stimulation (iTBS) describe different aspects of treatment. dTMS refers to the coil and device approach, whereas iTBS refers to a particular pattern of magnetic pulses. Some dTMS systems can deliver an iTBS protocol for major depressive disorder, allowing the magnetic stimulation to be delivered in a shorter session than conventional high-frequency protocols.

What Conditions Can dTMS Treat?

Clinical evidence supports the use of dTMS for selected patients with the following conditions:

  • Obsessive-compulsive disorder (OCD) dTMS targeting networks that include the medial prefrontal cortex and anterior cingulate cortex may reduce symptoms in adults who have not responded adequately to medication and psychological treatment.
  • Major depressive disorder (MDD) H-coil dTMS may be considered for adults experiencing a depressive episode who have not achieved satisfactory improvement from previous antidepressant treatment.
  • Other conditions Research is continuing into the use of TMS for other psychiatric, neurological and pain-related conditions. Evidence, device approval and treatment availability differ by condition, so these uses require specialist assessment.

Potential Benefits of dTMS

  • Non-invasive outpatient treatment dTMS does not require surgery or anaesthesia and is typically delivered in an outpatient clinic.
  • Focused brain stimulation The magnetic pulses are directed towards cortical networks associated with the condition being treated.
  • Generally well tolerated Most reported side effects are temporary and occur around the head or treatment site rather than throughout the body.
  • Different protocol options The treating clinician can select an appropriate coil, stimulation pattern and treatment schedule. For certain patients with MDD, an iTBS protocol may shorten individual treatment sessions.
  • Can complement existing care When clinically appropriate, dTMS may form part of a broader treatment plan that includes medication management and psychological therapy.

Side Effects and Safety

Common side effects can include a temporary headache or discomfort at the stimulation site. Jaw, facial or neck discomfort and muscle twitching can also occur. Rare but more serious risks, including seizure, are considered during clinical screening.

People with certain metallic objects or implanted devices in or near the head may not be suitable for treatment, and hearing protection is used during sessions. A qualified clinician must review each person’s medical history and determine whether dTMS is appropriate.

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