ट्रांसक्रैनियल मैग्नेटिक स्टिमुलेशन (TMS)

Transcranial Magnetic Stimulation (TMS) at PYONG Rehabilitation Penthouse

 

TMS (Transcranial Magnetic Stimulation) is a non-invasive neurostimulation technology that uses a specialized coil to generate magnetic pulses, inducing a low electrical current in targeted areas of the brain. This technique is non-surgical, requires no anesthesia, and takes a short time per session. It is suitable for individuals seeking to recover brain and nervous system function, such as patients post-stroke, Parkinson’s disease, cognitive impairment, and those needing mood and sleep therapy. At PYONG, every step is performed by a Rehabilitation Medicine specialist and a multidisciplinary team to appropriately determine the stimulation location, frequency, and personalized treatment plan.

PYONG Rehabilitation Penthouse is located on the 11th Floor of Gaysorn Tower (BTS Chidlom), offering convenient access in the heart of Bangkok with comprehensive rehabilitation technology.

 

What is TMS?

TMS is a technology that uses short, repetitive magnetic pulses (repetitive TMS; rTMS) to modulate the activity of neural circuits in the brain related to movement, muscle control, mood, and cognition. TMS stimulation can be designed to increase (facilitation) or decrease (inhibition) brain activity in the target area, depending on the frequency and protocol used.

The key advantages of TMS are that it is non-surgical and requires no general anesthesia. Common side effects are mild scalp irritation or headache, which are often relieved by over-the-counter pain medication. TMS safety standards are guided by international experts and are widely used in neurobehavioral and rehabilitation clinics to support the recovery of neural networks in various neurological disorders.

 

Why Choose TMS at PYONG Rehabilitation?

• International Standard Technology: The TMS machine at PYONG Rehabilitation is an internationally standardized model approved by the US FDA and the European Union.

• Diverse Treatment Modes: It features three diverse treatment modes—1) Traditional Biphasic Pulse, 2) Theta Burst Stimulation (TBS) for accelerating treatment effects, and 3) Pair Stimulation for bilateral brain stimulation (compared to typical TMS which often has only Biphasic Pulse).

• High Power & Precision: The TMS at PYONG Rehabilitation has a high magnetic strength of up to 3 Tesla, accessing deeper brain structures than standard TMS, and a wide frequency range of , suitable for personalized treatment planning for maximum efficacy.

• Physician-Led Care: A Rehabilitation Medicine specialist is the primary supervisor, assessing treatment goals and setting the plan to accurately address the neurological condition.

• Comprehensive Treatment Program: Integrates TMS with physical/occupational therapy, speech therapy, clinical psychology, and nutrition for holistic results.

• Full-Spectrum Technology: Features comprehensive examination rooms and modern equipment, adhering to international safety guidelines.

• Convenient Central Location: Gaysorn Tower, 11th Floor (BTS Chidlom), convenient for patients and caregivers.

• Personalized Plan: Progress is monitored periodically, and the treatment plan/frequency is adjusted based on the patient’s response.

 

 

 

How Does TMS Work?

The principle of TMS is to release magnetic pulses through a coil placed on the scalp. The magnetic pulse converts into a low-level electrical current in the cerebral cortex, enabling neurons to undergo “new learning” (neuroplasticity) and adjusting the strength of connections between brain cells (synaptic plasticity).

Steps in Summary:

1. Physician Assessment: History taking, neurological exam, readiness test, identifying contraindications/precautions, and selecting the target brain area.

2. Parameter Setting: Measuring the Motor Threshold to determine the appropriate energy level, setting the frequency/number of pulses/number of blocks.

3. Procedure: The client sits comfortably during treatment, may feel a slight tightening on the scalp, and the session lasts approximately 20–40 minutes.

4. Follow-up: Symptom assessment, with the physician adjusting the treatment plan weekly based on the client’s response.

Clients require no downtime and can resume normal activities immediately.

 

Conditions Suitable for TMS

• Movement recovery post-Stroke.

• Reducing spasticity/modulating motor networks in Parkinson’s disease.

• Supporting cognitive function in Cognitive Impairment/Alzheimer’s.

• Mood disorders such as Major Depressive Disorder (MDD) (approved in many countries).

• Certain types of anxiety.

• Certain sleep problems.

• Chronic pain/neuropathic pain.

• Post-Traumatic Brain Injury (TBI) in the context of rehabilitation medicine.

• Elderly individuals seeking to enhance brain performance and balance alongside an intensive rehabilitation program.

• Specialized cases where the physician deems neuromodulation of brain networks necessary.

 

Academic Evidence on TMS

• Safety and Standards: International guidelines by experts (IFCN) provide recommendations on safety, protocols, and training to ensure the responsible use of TMS and minimize risks, such as screening patients for a history of seizures and implanted devices before the procedure. (PubMed, ScienceDirect)

• Stroke/Movement: Multiple Meta-Analyses report that rTMS may help improve arm–hand function and overall motor function when the appropriate location and frequency are selected, with a positive trend during the recovery phase when combined with physical therapy. (PubMed, BioMed Central)

• Parkinson’s Disease: Recent Meta-Analyses suggest that high-frequency TMS over the Supplementary Motor Area (SMA) has the potential to help with some motor symptoms/gait, although evidence quality varies. (Lippincott Journals, Nature, PMC)

• Alzheimer’s/Cognition: Research indicates that rTMS combined with occupational therapy and cognitive training may help improve some aspects of cognition. (PubMed, Frontiers)

• Mood/Anxiety: TMS is cleared for marketing for the treatment of MDD in many countries and OCD in the US. (U.S. Food and Drug Administration, PMC, Oxford Academic)

Note: Results vary depending on the diagnosis, stimulation site, frequency, number of sessions, and combination with other rehabilitation programs.

 

 

Recommended TMS Frequency

Frequency depends on the treatment objective and condition, typically with a plan of 2–5 sessions/week for 2–6 weeks, followed by assessment to adjust the next protocol. Examples include:

• Neurorehabilitation (Stroke/Parkinson’s): Often planned alongside physical/occupational therapy to reinforce real-life skill practice.

• Mood/Anxiety/Sleep: May be set at a moderate, consistent frequency initially, with adjustment based on response.

At PYONG Rehabilitation, every case begins with an assessment by a Rehabilitation Medicine physician to determine the appropriate number of pulses, frequency, target location, and integration with other rehabilitation programs for the individual patient.

 

When to Expect Results

Some clients may feel minor changes, such as improved sleep quality/muscle tone/focus, within the first 1–2 weeks. However, achieving goals in motor or cognitive development usually requires several weeks of continuous repetition combined with rehabilitation training (e.g., physical/occupational therapy) for sustainable brain learning (neuroplasticity).

After the first course is completed, the physician will assess the results and plan the subsequent course as needed. Outcomes are individual and depend on age, time since onset, severity, complications, and family/caregiver involvement.

Contraindications and Precautions

TMS is considered safe when performed according to standard guidelines by an experienced team. The most common side effects are temporary headache/scalp tension. The risk of inducing a seizure is very low in individuals without risk factors and is minimized by appropriate screening. Key contraindications for the procedure include:

• Individuals with a pacemaker, neurostimulator/nerve stimulator, cochlear implant, or metal/implanted devices in the skull near the stimulation area.

• Uncontrolled epilepsy, pregnancy (case-by-case consideration), acute infection/fever, uncontrolled high blood pressure.

Before starting any case, we conduct a medical history review and safety screening according to international guidelines and closely monitor for side effects during and after the procedure. (PubMed, PMC)

 

 

Cost

The cost for TMS is 6,000–8,000 Baht/session (THB), depending on the chosen package. For clients participating in an intensive rehabilitation program, TMS may be integrated with training by the multidisciplinary team within the program. The actual price depends on the assessment by the Rehabilitation Medicine physician and the specific individual treatment goals.

Frequently Asked Questions (FAQ) — 5 Questions

1) Is TMS painful?

Mostly, you will feel a twitching/tapping sensation on the scalp or the sound of the pulse. No anesthesia is needed. Minor headaches can be relieved with common pain medication.

2) How many sessions are needed to see results?

Generally 2–5 sessions/week for 2–6 weeks, followed by assessment. The answer depends on the disease and individual response.

3) How safe is it? Is there a risk of seizure?

There are clear screening guidelines to minimize risk. The risk of seizure is very low in those without predisposing factors, and the medical team monitors closely. (PubMed)

4) Can TMS be used for depression/OCD?

In many countries, TMS is approved for Major Depressive Disorder (MDD), and in the US, it is approved for OCD under specific indications. (U.S. Food and Drug Administration)

5) Can it be used with other rehabilitation treatments?

Yes, it is recommended to combine it with physical/occupational therapy, cognitive training, and psychological care to enhance brain learning and sustainable results.

Choosing a clinic for pain and neurological disorders, overseen by expert specialized physicians like PYONG Rehabilitation Clinic and PYONG Rehabilitation Penthouse, ensures patients receive effective and safe care with modern technology. This increases the opportunity for patients to recover and regain a better quality of life quickly. If you are interested, please feel free to contact us.

PYONG Rehabilitation Penthouse ट्रांसक्रैनियल मैग्नेटिक स्टिमुलेशन (TMS) प्रदान करता है, जो तंत्रिका संबंधी और मूड विकारों के लिए एक नॉन-इनवेसिव थेरेपी है, जिसे US FDA और EU द्वारा अनुमोदित किया गया है। यह सेवा केंद्रीय बैंकॉक स्थान पर विशेषज्ञों के नेतृत्व में व्यक्तिगत, उच्च-सटीकता उपचार प्रदान करती है।