This method uses short magnetic pulses, comparable in strength to a traditional MRI, to achieve precise neuromodulation of the brain’s bioelectrical activity.

A TMS coil is placed on the scalp, in the predefined location, for instance over the motor cortex. When electric current flows through the coil, it generates a magnetic field, which in turn induces an electric field in the brain – in accordance with Faraday's Law – stimulating neurons.

TMS devices produce impulses that penetrate the brain tissue to a depth of approximately 3–4 cm, triggering what is known as a depolarising current in the neurons. This stimulation directionally changes cortical activity in the targeted region, and through trans-synaptic modulation, it also influences surrounding brain structures.

TMS promotes neuroplasticity by stimulating the release of neuroprotective substances and neurotransmitters such as serotonin. It also supports the formation of new neural connections (neurogenesis).

Traditional treatments in neurology and psychiatry mainly rely on pharmacotherapy, i.e. administering substances that affect the nervous system and brain chemistry. TMS, in contrast, does not involve introducing external substances – it stimulates the body’s own production of neuroactive compounds, thereby promoting change.

These changes occur on three levels:

• Neuronal: TMS triggers neuronal activity – either suppressing overactive structures or activating underperforming regions.
• Synaptic: TMS sessions over time stimulate the production of neurotransmitters (e.g. dopamine) and growth factors such as BDNF.
• Network-level: These neurochemical changes promote broader neuroplasticity within brain structures, helping to repair or compensate for dysfunction in the brain’s neural networks.

TMS utilises neuroplasticity – the brain's natural ability to repair and reorganise itself – by stimulating and guiding this process. Learn more about neuroplasticity and how it is used in TMS therapy.

TMS - A safe and effective non-pharmacological option for your mental health.

TMS works where medication has failed or cannot be used – in some cases, TMS can completely replace pharmacotherapy. This is especially relevant for individuals for whom medication was ineffective or caused too many adverse effects.

TMS can enhance the effectiveness of medications – studies have shown that TMS can improve the outcomes of certain drugs, achieving better results than either treatment alone. TMS can help reduce medication dosage – it can be used to lower doses and minimise side effects.

TMS offers hope even in the most difficult cases where standard treatment has failed. Between 50% and 70% of people with treatment-resistant depression experience clinically significant improvement after TMS therapy. And it’s not just depression – TMS has a broader therapeutic potential. See below what conditions can be treated with TMS.

TMS is uniquely non-invasive.

While TMS is officially approved for treating depression in adults by the FDA, it is also safely used in children [1]. TMS for children is available worldwide, including at Cook Children's Medical Center.

At Magwise, we have extensive experience with TMS. For children, TMS is always administered by a qualified specialist in child and adolescent psychiatry.

“TMS therapy demonstrates a strong safety and efficacy profile in minors – with minimal side effects compared to antidepressants. Moreover, TMS does not negatively impact cognitive function, brain maturation, motor development, or neural activity (e.g. receptors or neurotransmitters).” [2]

Clinical Uses of TMS in Children

Numerous clinical studies have shown that TMS is safe and effective in treating various conditions in children, including:

• Depression
• Autism spectrum disorders (ASD)
• Attention deficit disorders (ADHD/ADD)
• Tourette's syndrome

As with adults, there are many other potential indications and protocols for paediatric TMS.

Proven Safety and Efficacy

The safety and efficacy of TMS in children has been confirmed in studies involving over 3.5 million stimulations [3]

References

• [1] Narang P, Madigan K, Sarai S, Lippmann S. Is Transcranial Magnetic Stimulation Appropriate For Treating Adolescents with Depression? Innov Clin Neurosci. 2019 Sep 1;16(9-10):33-35. PMID: 32082948; PMCID: PMC7009324.
• [2] Qiu H, Liang K, Lu L, Gao Y, Li H, Hu X, Xing H, Huang X, Gong Q. Efficacy and safety of repetitive transcranial magnetic stimulation in children and adolescents with depression: A systematic review and preliminary meta-analysis. J Affect Disord. 2023 Jan 1;320:305-312. doi: 10.1016/j.jad.2022.09.060. Epub 2022 Sep 27. PMID: 36174786.3.
• [3] Zewdie E, Ciechanski P, Kuo HC, Giuffre A, Kahl C, King R, Cole L, Godfrey H, Seeger T, Swansburg R, Damji O, Rajapakse T, Hodge J, Nelson S, Selby B, Gan L, Jadavji Z, Larson JR, MacMaster F, Yang JF, Barlow K, Gorassini M, Brunton K, Kirton A. Safety and tolerability of transcranial magnetic and direct current stimulation in children: Prospective single center evidence from 3.5 million stimulations. Brain Stimul. 2020 May-Jun;13(3):565-575. doi: 10.1016/j.brs.2019.12.025. Epub 2019 Dec 30. PMID: 32289678.

Currently, the most commonly used TMS protocols involve repeated magnetic pulses (rTMS) at frequencies of:

• 10 Hz – excitatory
• 1 Hz – inhibitory

Another form is theta-burst stimulation (TBS), where pulses are delivered in triplets at 50 Hz. TBS allows for significantly shorter treatment durations (e.g. accelerated iTBS or aiTBS), often completed over just a few days, and is generally better tolerated than standard protocols.

A variety of brain regions can be targeted during treatment. Common targets include:

• Bilateral prefrontal cortex
• Premotor cortex
• Motor cortex
• Broca’s area

The exact stimulation target and protocol details are determined during a qualifying consultation performed by a physician.

SAINT (Stanford Accelerated Intelligent Neuromodulation Therapy) is a modern, personalised protocol of TMS developed by Professor Nolan Williams and his team at the Brain Stimulation Lab at Stanford University, California.

Dr Nolan Williams, Professor of Psychiatry and Neurology at Stanford University and creator of the SAINT protocol: “It works quickly and it’s non-invasive.”

What is the SAINT protocol?

SAINT involves an intensive stimulation programme: the patient receives 50 sessions over 5 days (10 sessions per day, every 50 minutes), equivalent to six standard TMS courses in terms of pulse count. What sets SAINT apart is the precise targeting. Unlike conventional protocols, SAINT uses functional MRI (fMRI) to identify the exact location in the left dorsolateral prefrontal cortex (DLPFC) that is most anti-correlated with the subgenual anterior cingulate cortex (sgACC).

Why does this matter? A strong anti-correlation between the DLPFC and sgACC is key – DLPFC activity can inhibit the overactivity of the sgACC, which is linked to depressive symptoms. Targeting this specific site increases the likelihood of effectively “resetting” dysfunctional neural networks.

Advantages of the SAINT accelerated protocol

• Exceptional efficacy – clinical studies show that around 80% of patients with treatment-resistant depression achieved remission. This is among the highest success rates recorded in depression treatment.
• Rapid treatment – the full protocol lasts only 5 days, making SAINT one of the fastest available TMS therapies.
• Highly personalised – using fMRI and analysis of functional connectivity between DLPFC and sgACC, the stimulation is tailored to the individual neurobiology of each patient.
• FDA approval – in 2022, the SAINT® Neuromodulation System developed by Magnus Medical received official FDA clearance for the treatment of medication-resistant depression.

SAINT at Magwise

Since 2020, Magwise has been offering a 5-day SAINT-inspired protocol using craniometric targeting, with hundreds of satisfied patients.