TMS versus DBS Treatments for Depression

Doctor Abraham Zangen discusses two techniques for treating depression, which involve electrically stimulating the brain - transcranial magnietic stimulation (TMS) and deep brain stimulation (DBS).

The deep brain stimulation is a method in which you insert an electrode to a specific brain region, you leave the electrode inside, you need a surgery for that, and you give repeated stimulation. It is a chronic stimulation. You could just stimulate a few minutes per day or a few hours per day, but usually with DBS (deep brain stimulation), there is a chronic stimulation and it is used mainly for Parkinson’s disease today. There are many studies showing some efficacy in depression and this is what DBS is all about – stimulating the brain chronically. With TMS, you do not need any surgery; however, of course, you can only give a few minutes like 15 minutes per-day of stimulation and you are trying to modulate, to make long-term effects by this daily treatment, and not to hold the stimulation and affect the brain throughout the day, so it is a different concept. It is the same idea of changing the electrical activity of the brain because TMS, a magnetic stimulation, eventually is producing an electric stimulation just like an electrode inserted in the brain, but you do not need the surgery. You put the coil over the head, and you give daily sessions of 15 to 30 minutes maximum and you are trying to induce long-term alterations like changes in BDNF levels by the daily sessions that will actually maintain the effect for longer periods. In DBS, you are actually trying to modulate it all the time by giving pulses throughout the day.