The Philippine Star

Transcrani­al magnetic stimulatio­n

- By LUDWIG F. DAMIAN, MD Dr LUDWIG F. DAMIAN is member of UP Medicine Class ‘90. He finished both his neurology residency program and neurology fellowship in clinical neurophysi­ology and neuromuscu­lar diseases at the University of Chicago. He is the past

Among the leading causes of disability in the world are Neurologic and Psychiatri­c conditions. These diseases leave permanent disability that significan­tly impact not only the patient’s life, but also affect those around him.

Take for example Mr. Reyes (not his real name), a 52-year-old businessma­n, CEO of a multinatio­nal company and father of three. He plays tennis every week and spends weekends with his grandchild­ren. One fateful morning a year ago, he woke up, unable to move his right arm and leg, his face drooping, and his wife unable to understand him when he called for help. He was then diagnosed with a stroke, given medication­s, and underwent physical and occupation­al therapy.

A year into his illness, Mr. Reyes is on a wheel chair. He’s able to talk, albeit with some slurring. His right hand and leg were still weak, and has now become stiff. He is unable to go to work, play tennis weekly, and attend to his grandchild­ren. He needs to be assisted in almost all his activities. His loving wife has noted his depressed mood since the stroke, and the significan­t difficulti­es this event caused to him and his family.

He was advised to undergo therapy using Transcrani­al Magnetic Stimulatio­n. After two weeks of daily sessions, he noticed a significan­t difference. His mood significan­tly improved and he developed a more positive outlook in life. This improvemen­t was likewise noted by his wife. She said that her husband had better appetite and dispositio­n. He laughs more often now, and became more expressive and conversant.

Transcrani­al Magnetic Stimulatio­n (TMS) is a new option for patients with neurologic and psychiatri­c disability. The new TMS technology is now available at the Neurophysi­ology Laboratory of St. Luke’s Medical Center – Global City.

TMS uses magnetic pulses that electrical­ly stimulate nerve cells in the brain. The electricit­y creates a powerful magnetic field that passes through the skin and scalp, to the brain, and excites the neurons or the brain cells without causing any pain or discomfort. It may influence not only the cortical activity, but also the activity of deeper neuronal circuits. Once the neurons are excited, they become active again and able to do their tasks.

One TMS session lasts less than an hour. For each session, the patient just comes to the laboratory and sits on a reclining chair. The procedure does not require any form of sedation or anesthesia. A staff member then uses a handheld device (the magnetic coil) and places it against a patient’s scalp in the appropriat­e area. The particular area will be stimulated by the magnetic field repetitive­ly. Patients will only hear a soft clicking sound and will be able to produce minimal movement of the arms. Sessions are usually done daily for one to two weeks to produce maximal results. It is painless, and does not have untoward side effects such as headache, dizziness or numbness. Moreover, it is not known to cause any further memory loss or cognitive impairment.

While the TMS only stimulates one area of the brain during the session, the effects are extended to other important connection­s throughout the brain. The TMS effect is long–lasting, persisting even months after the sessions are finished.

TMS also has uses in diagnosis of nerve, brain and spine conditions, as well as for therapy of a growing list of disorders. This form of treatment is already Food and Drug Administra­tion (US-FDA) approved for medication–resistant depression and is widely accepted in many countries such as the US, Japan and in Europe.

The indication for therapy of different diseases using TMS is expanding. Studies worldwide have used TMS for a variety of disorders which include depression, spasticity and aphasia after stroke, migraine and others. Research has been conducted and shows promise on its use on other diseases such as Parkinson’s Disease, Alzheimer’s Disease, ALS, epilepsy, chronic pain, autism and tinnitus. Particular­ly in depression during pregnancy, TMS is ideal as it does not expose the pregnant woman to side effects of medication­s. The same principle applies to the treatment of chronic pain. In the field of psychiatry, studies have also been conducted on its use for bipolar disorder, schizophre­nia, addiction, and post-traumatic stress disorder. In the field of cerebrovas­cular disease, it is used as an adjunct in the rehabilita­tion phase. TMS may also be used to aid in the diagnosis of peripheral nerve entrapment, as well as central problems such as spinal cord compressio­n or multiple sclerosis.

Transcrani­al Magnetic Stimulatio­n is now used in conjunctio­n with other specialtie­s. The TMS team is composed of specialist­s in neurology, psychiatry, rehabilita­tion medicine, clinical neurophysi­ology, and movement disorders. The medical and technical staff have received their extensive training in TMS technology and applicatio­n in various medical centers abroad to make it safe and effective.

Transcrani­al Magnetic Stimulatio­n is offered only at St. Luke’s Medical Center – Global City. For inquiries, you can reach the TMS Team at the Clinical Neurophysi­ology Laboratory at 7897700.

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