Discover more from From Brain to Mind
Magnetic hemet, designer mind
TMS is healing brain maladies and foraying into the field of designer mind
Transcranial magnetic stimulation (TMS) is a technology that involves wearing a helmet or having pads placed over your scalp and having magnetic pulses delivered to specific areas of the brain. It has been a United States Food and Drug Administration (FDA) approved treatment for a variety of psychological and neurological indications:
TMS has been FDA approved for treatment of Major Depression since 2007. The Australian Medicare system recently jumped on the bandwagon and approved TMS as a treatment for depression. It is normal to feel sad from time to time, but depression is different. It is a loss of ability to experience any pleasure and a loss of motivation that becomes disabling. It will strike up to 20% of people at some time in their lives. TMS treatment is currently widely available, being administered at clinics, both private and at academic centers, throughout the USA. The brain target for the magnetic energy is the left sided dorsolateral prefrontal cortex (an area of the brain responsible for decision making and attention control). The results of treatment have been published in academic journals and individual patient anecdotes have leaked into the lay press.
In 2013, the FDA also approved TMS for treatment of certain types of migraine headaches (those preceded by an aura (visual disturbances). The brain target for the magnetic energy is the occipital cortex (an area of the brain responsible for vision). About 12% of people suffer from migraine headaches and about a third of those have auras.
In 2018, TMS was approved by the FDA for treatment of obsessive compulsive disorder (OCD). People who suffer from OCD have recurring thoughts, which they cannot dispel, and recurring urges to repeat behaviors, which they cannot resist. About 2% of the population will suffer from OCD at some point during their lives. More recently, Australians have embarked on a trial of TMS to treat OCD. In 2021, researchers in Melbourne recruited 75 volunteers to determine the safety and effectiveness of TMS for OCD in the Australian patient population. The brain targets for the magnetic energy are the medial prefrontal cortex (a part of the brain that helps consolidate and retrieve memory and social cues and information) and the anterior cingulate cortex (communicates between emotional parts of brain and thinking/action/sensory parts of brain).
In 2020, TMS was approved for the treatment of cigarette (tobacco, nicotine) smoking addiction. Up to 20% of people in the developed world are smokers, more than half of whom are trying to quit. The brain target for the magnetic energy is the left sided dorsolateral prefrontal cortex (an area of the brain responsible for decision making and attention control). The same target may also be used for therapeutic intervention for other substance abuse disorders (i.e. drugs).
In 2021, The FDA granted Breakthrough Device Certification for a device that works somewhat differently. The device, manufactured by a company called BrainQ, improves recovery after stroke or brain injury. It uses machine learning AI (artificial intelligence) algorithms to evaluate EEG (electroencephalogram) after a patient has suffered a stroke or traumatic brain injury. Like TMS, it delivers magnetic energy, but at a much lower energy. The treatment aims to reprogram the damaged area of the brain by taking advantage of the brain’s innate neuroplasticity (ability to rewire neuronal (brain cell) circuitry).
In the USA, many insurers will pay for some or all of the above indications.
Outside the USA the devices are approved for a wider variety of purposes. Bipolar disorder, Post traumatic stress disorder, schizophrenia, Alzheimer’s disease, Autism, Chronic Pain, Multiple Sclerosis, Parkinson’s Disease, Post stroke rehabilitation.
Experimentation continues on other indications for TMS. In a 2020 study, researchers directed high strength magnets to help fight pathologic fearfulness. The scientists used TMS for patients suffering from fear and anxiety. They directed the TMS at a part of the brain called the intraparietal sulcus (a part of the brain involved with abstract thought (such as mathematics) and determining the intentions of other people). The doctors reported that magnetic stimulation of the intraparietal sulcus was effective in treating fear and anxiety. The same group of scientists, in another 2020 publication, reported their results after studying another area of the brain. The doctors were able to induce a state of fear and anxiety after using TMS to activate the right (but not left) dorsolateral prefrontal cortex (an area of the brain responsible for decision making and attention control). (please compare to TMS target for depression and substance abuse, listed above, and memory improvement, listed below)
Some researchers are not looking to fix what’s broke. They’re instead trying to build a better brain. A group of Glasgow scientists reported, in 2021, that transcranial magnetic stimulation may improve your memory. The researchers discovered that TMS boosted verbal memory (recalling words). The particular brain target they used was the dorsolateral prefrontal cortex on the left side (an area of the brain known for the control of highest level executive functions).
It is not just academia that is exploring the limits of TMS. A private company is betting that transcranial magnetic stimulation may be safe for the treatment of Alzheimer's Disease. A startup company called Actipulse, based in Massachusetts, reported on their study of 34 human volunteers with mild cognitive impairment from Alzheimer’s. Although they demonstrated that the treatment was safe, they did not report any improvement in neurological status.
Investors may be interested in companies that manufacture devices which deliver TMS (described in this video and to follow)
Neuronetics produces a TMS machine called NeuroStar. It is being marketed to treat Depression. It trades on nasdaq as STIM. Its Market Cap in July, 2021 is $350 million.
Greenbrook produces a TMS machine. It is being marketed for Depression, OCD and smoking. It is a Canadian company and trades on NASDAQ as GBNH. Its Market Cap in July 2021 is $195 million.
Brainsway produces a TMS machine called DeepTMS. It is being marketed for all of the above indications (Depression, OCD and smoking in the USA and worldwide and other indications worldwide outside the USA). It is an Israeli company, whose ADR trades on NASDAQ as BWAY. Its Market Cap in July 2021 is $152 million.
Magstim produces a family of TMS based devices. It is being marketed to treat depression. It is a privately held company in the UK.
Brain Ultimate produces a family of TMS based devices. It is being marketed to treat depression and research a host of other neurological maladies. It is a privately held company in China.
MagVenture produces a family of TMS based devices. It is being marketed to treat depression and OCD. It is a privately held company in Denmark.
eNeura produces a TMS machine called SpringTMS or Cerena. It is being marketed to treat Migraine. It is a privately held company in the USA.
Neuroprex is a privately held American company that is marketing a TMS machine for depression and other neurological ailments.
Axilum produces a robotic device to administer TMS. The company is based in France and its capital is held by several individuals and other companies.
Cloud Neuro LLC produces a TMS device called Cloud TMS that is designed to be portable. It is being marketed to treat depression. It is a privately held multinational corporation.
Nexstim produces a machine called SmartFocus TMS. It is being marketed for the treatment of depression and pain. It is a Finnish company whose shares trade in Stockholm and Helsinki.
Mag & More produces the Apollo machine to deliver TMS. It is being marketed for the treatment of depression, pain, tinnitus, incontinence, paresis, migraine, stroke, schizophrenia and anxiety. It is a privately held German company.
Neurosoft manufactures the Neuro-MSX machine to deliver TMS. It is being marketed for the treatment of depression. It is a privately held Russian company.
Salience manufactures the Star*D machine to deliver TMS. It is being marketed for the treatment of depression. It is a privately held American company.
BrainQ is an Iraeli startup. In the summer of 2021 the company raised $40 million to take it’s device to market.