TMS Machine | What are TMS Machines & How they Work

What Are the Components of a TMS Machine?

A TMS machine comprises three key components:

1. The Chair: Designed for patient comfort, these chairs often have adjustable features to ensure the patient can relax throughout the treatment session.
2. The Coil: An electromagnetic coil delivers magnetic pulses to target specific brain regions, addressing symptoms of mental disorders.
3. Magnetic stimulator: Also referred to as the protocol tool. This is the TMS machine’s main unit, operated by a computer that the TMS consultant can use to manage the coil, stimulation protocols, patient data, and treatment reports.

What Types of TMS Machines Are There?

TMS machines generally fall into two categories, depending on their function and use: repetitive transcranial magnetic stimulation (rTMS) therapy or deep TMS therapy. In Australia, the Therapeutic Goods Administration (TGA) has approved TMS machines for both rTMS and deep TMS therapy.

There are a few notable TMS machines manufactured in different regions of the world. We’ve summarised the most popular and effective TMS machines on the market today:

1. Neuro-MS

The Neuro-MS machine is manufactured by Neurosoft, and is TGA-approved for stimulating the peripheral or central nervous system through magnetic stimulation. At Neuralia TMS, the Neuro-MS is our preferred TMS machine.

The Neuro-MS has shown promise in the treatment of neurological and mental conditions. This machine can yield long-lasting alterations in brain activity by producing an alternating magnetic field that activates neurons. Predetermined and customise treatment protocols, an intuitive user interface, and state-of-the-art Neuro-MS.NET software for patient database management and protocol control are all included in Neuro-MS.

When it comes to hardware, the Neuro-MS features a cooled angulated figure-8 coil for focused stimulation, a flexible arm for coil positioning, and a liquid cooling system to minimise overheating. This TMS machine provides high-frequency stimulation up to 30 Hz (expandable to 100 Hz) for various treatments, and a robust industrial connector for safe and dependable coil attachment. Moreover, the Neuro-MS offers compatibility with navigation systems for MRI-guided stimulation, and a range of coils for diverse treatment requirements.

2. BrainsWay Deep TMS

The BrainsWay Deep TMS machine is manufactured by BrainsWay. This TMS machine has found much success in both the United States and Australia, and is approved by both the FDA and TGA. The BrainsWay machine provides deep TMS by making use of a uniquely designed H-coil, which is housed inside a helmet. The H-coil structure is designed to maximise electrical stimulation.

Coils that provide deep rTMS, like the ones used on the BrainsWay don’t come with navigation systems. Instead, the patient will put the helmet on and a connection between the brain and helmet will be established. The BrainsWay Deep TMS machine is typically used for major depressive disorder (MDD) and obsessive-compulsive disorder (OCD) treatments that last around 20 minutes per session.

3. MagVenture

MagVenture manufactures a range of TMS machines including stimulators, coils, and accessories for TMS treatments. A popular option is MagPro R30, which is one of MagVenture’s many devices approved by the FDA for treating MDD and OCD. The MagPro R30 stimulator can provide both rTMS and theta burst stimulation (TBS).

TBS therapy is quite different from traditional TMS and Deep TMS treatments. These sessions last around 3 minutes, but they are done in a repetitive fashion (rTMS). The TBS protocol has been shown to be just as effective at treating disorders like depression.

4. Navigated Brain Therapy (NBT) System

The Navigated Brain Therapy (NBT) System is manufactured by Nexstim, and is a little different from the TMS devices we’ve mentioned above. This device provides brain-mapping protocols, and its technology was originally used to help neurosurgeons plan brain surgery.

In the modern era, however, the NBT System has been increasingly popular as a TMS treatment machine. This TGA-approved machine is used to treat MDD by focusing on the patient’s dorsolateral prefrontal cortex and applying non-invasive rTMS stimulation to that area.

5. MEGA-TMS

MEGA-TMS, manufactured by Soterix Medical Inc., is an FDA-approved TMS machine specifically for the stimulation of peripheral nerves for diagnostic purposes. However, it has not yet been approved by the TGA. The MEGA-TMS has the greatest maximum voltage-rated capacitor in its class, so it can provide single-pulse stimuli with more power. The MEGA-TMS machine can also be used for brain mapping, diagnostics, and assessments.

MEGA-TMS supports six different types of coils, and it is the only TMS system that enables complete API control over device parameters. Notably, MEGA-TMS is currently being used in a trial for stroke recovery research, funded by the National Institutes of Health (NIH) in the US.

6. NeuroStar

The NeuroStar TMS machine was developed by Neuronetics, a company that was heavily involved in making clinical TMS depression treatment an accepted remedy. Neuronetics’ NeuroStar device was approved by the FDA for MDD in 2017 and OCD in 2022. It is not currently approved by the TGA.

The NeuroStar machine provides advanced brain stimulation therapy, especially for patients suffering from MDD, and who struggle to receive satisfactory improvement from antidepressant medications. The device uses a figure-8 coil and typically produces TMS treatment sessions that last around 19 minutes in total.

The NeuroStar device does not have a navigation system for coil placement like many other machines do. Instead, it has a special contact sensing strip that will let the consultant know if the connection between the head and coil is lacklustre.

How Do TMS Machines Work?

TMS machines work by using a small electromagnetic coil that’s controlled via a computer program. This coil is placed against the patient’s head and delivers short, powerful bursts of magnetic energy focused precisely on the left side of the brain’s frontal cortex.

TMS machines work in a very similar way to those used for magnetic resonance imaging (MRI) but are almost opposite to electroconvulsive therapy (ECT).

TMS Machine Approval in Australia vs USA

In Australia, TMS machines are regulated by the TGA. The TGA’s first approval of TMS machines in 2017 demonstrates the recognition of their effectiveness and safety. Similar to the FDA’s stance in the United States, where the FDA approved its first TMS machine in 2008.

TMS Machine Models and TGA Approvals in Australia

The first TMS machine to be approved in Australia was the Stereotactic neuronavigation/planning system, manufactured by Brain Science Tools B.V. in 2017.

The below list of TMS machines shows their manufacturer, name, and approval date.

*All above listed TMS machines were TGA registered as:

• Registration Type: Device
• Therapeutic Good Type: Medical Device

How Much Do TMS Machines Cost?

TMS machines differ wildly when it comes to pricing. Generally, clinics and practitioners can expect to pay anywhere up to $80,000 to purchase a high-quality, well-reviewed TMS machine.

FAQs