If you have been researching transcranial magnetic stimulation as a treatment for depression, you may have come across two terms that sound similar but are not identical: traditional TMS and Deep TMS. Both use magnetic pulses to stimulate the brain without medication or surgery, but they differ in how far and how broadly they reach into brain tissue. Understanding the distinction can help you make a more informed decision about your care.
How traditional TMS works
Traditional, or standard, TMS uses a figure-eight coil placed against the scalp to deliver magnetic pulses to a focused area of the brain. The pulses penetrate a relatively shallow depth, reaching the surface layers of the cortex. This approach has been used for years and is effective for many patients with depression. It earned FDA clearance for treatment-resistant depression and remains a widely available option. Its main limitation is that the magnetic field reaches a smaller, more superficial region of the brain.
How Deep TMS is different
Deep TMS, developed by Brainsway, uses a patented H-coil housed within a cushioned helmet rather than a handheld figure-eight coil. This design allows the magnetic field to reach deeper and broader regions of the prefrontal cortex. Because a larger area is stimulated, there is a greater likelihood that the magnetic pulses will reach the precise brain structures involved in mood regulation. The U.S. Food and Drug Administration has cleared Brainsway Deep TMS systems for the treatment of major depressive disorder and certain other conditions, and you can read about how such devices are reviewed through the FDA medical devices resource.
What the research suggests
Comparative studies have explored whether the deeper, broader stimulation of Deep TMS translates into better outcomes. Some research has reported higher response and remission rates with Deep TMS compared with standard TMS, along with a greater reduction in depression severity. While individual results always vary, the broader electrical field is thought to increase the chance that the correct area of the brain is effectively targeted. For a general overview of how brain stimulation therapies are studied and applied, the National Institute of Mental Health maintains a helpful resource on brain stimulation therapies.
What both approaches share
Whether you receive traditional TMS or Deep TMS, several important features remain the same. Both are noninvasive and require no anesthesia or sedation. Both let you remain awake and alert during treatment and drive yourself home afterward. Both avoid the systemic side effects of medication, such as weight gain and sexual dysfunction. And both allow you to continue your current medications during treatment. The most common side effects for either approach are mild scalp discomfort and transient headaches that tend to fade as treatment continues.
Which is right for you?
The choice between traditional and Deep TMS depends on your specific situation, your treatment history, and the equipment available at your provider. A consultation with a knowledgeable specialist is the best way to weigh the options. At Houston West TMS, William K. Drell, MD, provides Brainsway Deep TMS and can explain how it compares with other approaches based on your individual needs. To learn more, call (713) 464-4455 or request a consultation online today.
