Step 1:

Participant sits on a chair like the one in the picture, during the TMS treatment and will be offered small ear plugs to avoid any discomfort to their hearing. Before the treatment begins the participant will be put at ease.

Step 2: 

Before the treatment begins the clinician needs to determine something called the ‘motor threshold’. To determine the appropriate level for each individual, they first deliver short magnetic pulses so small twitches are noticed in the hand. This is done by placing the device on the scalp surface, directly above the brain region responsible for your hand movements (motor region). Measuring the motor threshold helps determine the strength of the magnetic stimulus required to stimulate brain cells. Your fingers will only twitch slightly during the motor threshold test and not during the TMS treatment.

Step 3: 

The clinicians will then place either a tracker on the right side of the participant’s forehead, using stickers or a headband. They will then use a special tracking wand to point at the bridge of the nose directly between the inner corners of the eyes and the small dimple in front of and at the top edge of the ear canal. This is so they register the position of your head, and so that they can find the correct spot to deliver the TMS treatment.

Step 4:

The clinicians will then position the device at a different brain region that is relevant for treating depressive symptoms. This will be determined either from your previously obtained brain scan or a standard region for TMS. You will receive a sequence of several short bursts of stimulation via the device. When the stimulus is being delivered, you may hear a clicking sound coming from the equipment.

Step 5:

You will be staying awake during the entire procedure, and will be able to read a magazine or listen to music if you wish to. But it is important that you do not move your head too much so the position of the device against your scalp does not move. The chair you will be sitting in will have a headrest to make it easier and more comfortable for you to keep your head still. Once you complete a treatment session, the person administering the TMS will complete a checklist for any side effects that you may have. You will be able to go home immediately after the session. You will not be put to sleep (no anaesthesia) or given any medications. You can drive or take public transport if you wish after the treatment.

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