We at MindPath Care Centers are always looking for new ways to work towards destigmatizing mental health in our world, whether that be through blogs, videos, or social media. Keeping that in mind, we decided to venture into podcasts, to bring you the voices of our providers and to talk about important mindcare topics.
Today, we’re discussing all things TMS – what is it? What are the side effects? Am I a candidate? And more!.
Below you’ll find the fifth episode of our podcast, “Let’s Talk Mindcare” with provider Sandeep Vaishnavi, MD, PhD, We hope you enjoy!
Read the Transcript:
Introduction: Hello, and welcome to Let’s Talk Mindcare, a podcast brought to you by MindPath Care Centers. MindPath is one of the largest outpatient mental health organizations in the Southeast US with over 25 locations and more than 180 providers. For the past 25 years, we have helped tens of thousands of patients across North America and now we’ve created this podcast to further commit ourselves to ending the stigma and continuing the conversation around mental health, through discussions with real mental health professionals. Please note, that while the podcast will include accurate information with professional input, it is not intended as a replacement for medical advice from licensed providers to receive such advice, please contact MindPath Care Centers at mindpathcare.com or call us at (877) 876-3783 and we will connect you with a professional who can further assist you. We hope you enjoy the episode.
Trent Brown (Host): Hi everyone. My name is Trent brown. I’m one of the hosts of the Let’s Talk Mindcare Podcast and I’m here with Dr. Sandeep Vaishnavi, who is the Medical Director of Clinical Trials Institute and Interventional Psychiatry here at MindPath Care Centers. So, Dr. Vaishnavi, can you tell us about yourself and you know, how you came to psychiatry and working on TMS, which is what we’re talking about today.
Sandeep Vaishnavi, MD, PhD: Sure. Yeah. I actually have been interested in the brain since elementary school, really since third grade and I’ve really always been fascinated in terms of brain-behavior relationships. How is it that the brain creates behavior and how is it that the brain really creates our perception of the world? Because if you think about it, really nothing is outside your brain. We think of everything, you know, the environment is being external, but it’s really a model that your brain creates. So that’s always been fascinating to me. And, so I eventually got interested in studies in neuroscience. So I got a PhD in cognitive science, specializing in cognitive neuroscience. Along with an MD. And then, I was really trying to choose between neurology and psychiatry – ended up going into psychiatry because of the brain-behavior relationships, which I’ve always found so fascinating, and then I did a fellowship in behavioral, neurology and neuropsychiatry. So ultimately kind of ended up doing a combination of things.
And then in terms of TMS, TMS is really applied neuroscience. So TMS, meaning Transcranial Magnetic Stimulation, it’s really utilizing what we’ve learned about neuroscience, neurocircuitry brain-behavior relationships, and actually applying them for different disorders, such as Major Depressive Disorder or OCD, or Smoking Cessation, which are the three current indications that are cleared by the FDA. So it was really a natural progression for me personally since I’ve just been so fascinated with the brain all along and now we’re in a position where we can actually utilize all this knowledge and actually help patients improve their symptoms.
Trent Brown (Host): Absolutely! Yeah, so let’s talk about TMS a little bit more. Can you tell me, you know, I’ve spent a long time learning it from having to write about it on our website and all that. Can you kind of explain what TMS is? You know, in simple terms for people and what does it treat? That kind of thing?
Sandeep Vaishnavi, MD, PhD: Sure. So TMS stands for Transcranial Magnetic Stimulation, and it’s really a form of neuromodulation. It’s basically a way to directly impact circuit networks in the brain. So you can think about all the treatments that we have right now in psychiatry. We have medications, of course, we have behavioral therapies. This is a third type of treatment, neuromodulation or brain modulation treatment. So with TMS, what we’re doing is we’re actually creating a magnetic field that goes right through your scalp, right into your brain and it induces firing off brain cells, firing off neurons in that area. And the reason we do that is because there’s an old saying in neuroscience that neurons, that fire together wire together.
So the concept there is that as we stimulate those brain cells over and over again, we actually induce those brain cells to form connections, physically form more connections. And as they form more connections, That part of the brain can do its job that circuit can do its job much more efficiently. So it’s kind of like building roads or building highways. The whole idea is that while we can allow traffic to flow more efficiently. So it’s the same concept, but in the brain with TMS, we’re actually causing changes in the brain infrastructure. Basically we’re building up infrastructure, we’re building up connections so that information can flow more freely and that circuitry can work more efficiently.
Because ultimately the brain is all about information processing. And if we can induce neuroplasticity, which means basically allow the brain to mold itself and change itself, nd that’s exactly what we’re doing with TMS, we can build up that infrastructure and we can actually improve the functioning of the.
Trent Brown (Host): Wow. Yeah, that is fascinating. I have to tell you that just explained it better than all of the reading I’ve done. Yeah. So, you mentioned this earlier, it treats depression right now for, for MindPath depression, OCD, and smoking cessation. Is that right?
Sandeep Vaishnavi, MD, PhD: That’s right. Those are the three current indications, psychiatric indications. So depression, the clearance from the FDA for depression has been around for some time, since 2008, approximately, and more recently for OCD, and now actually just this past year for smoking cessation. So TMS is really a platform. It’s really a technology platform. It’s not really specific, necessarily to certain diseases.
It’s basically, well, now lets under, we understand the neuroscience of this particular disorder. We understand what circuits are involved. We know how to modulate those circuits and TMS is a technological platform by which we can do that. We can modulate those circuits. This is just the beginning. As time goes on, I envision we’re going to have a lot of other things that we’re going to also be able to treat. I know that there are ongoing studies and in fact, I’ve taken part in some of these studies, in PTSD, for example, um, and then perhaps bipolar disorder in the future. Uh, maybe even things like mild cognitive impairment or early Alzheimer’s disease, there are a slew of possible brain disorders that TMS can treat, because we do have some clarity in terms of the neuroscience behind these disorders, we can then utilize this technology to modularly different circuits. So it’s not the same circuits that we’re targeting for these different disorders. They’re different circuits. So once we know the circuitry, we know how it’s applicable to a certain disorder. We can utilize that knowledge to target the TMS technology to a certain part of the brain. And we also have to look at what frequency we have to use and all kinds of technical things like that. But once all of that is done and all of that has been studied, we can then use this technology for all kinds of different disorders.
Trent Brown (Host): Yeah, well, that is very fascinating. I mean, for me, it’s just incredible talking about, you know, using it for different disorders and hopefully a lot more in the future. It’s just amazing to me how flexible this is.
Sandeep Vaishnavi, MD, PhD: Yeah, it really is. It’s really a different modality of treatment. It’s not, you know, it’s like medications, right?
So you have medications that can treat all kinds of different disorders. So TMS is like that it’s a modality, it’s a treatment platform. It’s a technological platform. It can be used for all kinds of different things as well.
Trent Brown (Host): Yeah. So, for someone listening to this that you know, is interested in it and may have depression or something else, can you talk to us about, if you’re the patient and you’re going in to get TMS, what is expected of you and you know, what are the lifestyle changes you have to make? What is the commitment like for that?
Sandeep Vaishnavi, MD, PhD: Right. Well, so TMS – The way I would think of TMS is that it’s not a cure for, let’s say for depression, let’s focus on that right now.
It’s not a cure for depression, but what it is is a means by which to change the brain state. So let’s say you’re in a certain brain state, not a very good brain state. What we can do with TMS is that we can actually change that brain state to a much better brain state. And after that, though, lifestyle changes, medications, therapy, all kinds of things like that can help in maintaining the benefits.
So let me kind of give it a little bit more detail about depression specifically. So what we’re doing with TMS for depression is that we’re targeting an area of the brain called the left prefrontal cortex. So it’s the left part of the front part of your brain, essentially and we’re targeting that part of the brain because it turns out that that part of the brain is really important in regulating your emotional networks. So the prefrontal cortex on the left is part of what we call the cognitive control network, and it helps control or regulate your emotional networks among other things. So in depression, as a simplification, emotional networks are two active and the cognitive networks are not active.
So, what we’re doing with TMS is that we’re kind of changing that balance. So we’re, upregulating the cognitive networks so that they can do their job better, which is to regulate the emotional network. So we don’t want to get rid of emotions. Of course, we want emotions. You can kind of think of emotions as a short, like kind of a heuristic or a shortcut for the brain because let’s say someone’s coming after you with a knife or something like that, you don’t want to have to sit down and think about what your next move is right?. You want to get out of there. Right. And that’s really an emotion that’s driving that in this case. So emotions can be very, very useful. In fact, there’s a theory in neuroscience, which has gotten a lot of credence over the years, that emotions are actually really important for optimal decision-making.
We need emotions and even with sadness, sadness can be an appropriate emotion for certain situations. But the problem with depression is that the patient is stuck in that state. So there’s a mismatch between what may be going on externally in the environment or what may be going on in their lives and their emotional state. They can’t get out of that emotional state. And that’s really a dysfunction of this cognitive control network because it really should be regulating those emotional networks. So, people are not stuck in that certain state. So our goal with TMS is to really kind of get things back to where they were, where they should be.
So let’s improve the efficiency of the cognitive control network, by targeting this prefrontal cortex area. And by doing it repetitively over time, we’re actually inducing those changes in the brain that I mentioned to you, the neuroplastic changes, creating that infrastructure. And so over time that that regulation of the emotional.
We’ll get better and better. So in terms of the actual treatment for the patient, it does involve coming into the clinic on a regular basis for a certain period of time, because we have to have the brain get stimulated over and over again. So that ultimately, as I said, neurons, that fire together, wire together.
And there’s another saying in neuroscience, that we’re really trying to tune and prune the brain. In other words, we want to really tune the brain so that the most efficient information processing can occur in these circuits and we don’t want to have connections that are useless. That’s the pruning part. So there’s a tuning and there’s pruning and all of this can happen via this mechanism of neuroplasticity, the brain changing itself. So. We, we have the patient come in for, uh, it’s usually about 20 minutes per session. It’s five days a week for six weeks for depression. That’s the acute course.
And then there’s six additional sessions or the next three weeks to wean off to help. So it’s a total of 36 sessions. And in the first session we actually fine tune the location and the strength of the magnet. We individualize that for each patient. So that can take some more time, but then we go ahead and do a treatment course, which is approximately 20 minutes per session, as I said, and then on a weekly basis, the doctor at MindPath will talk to the patient and do rating scales to find how to find out what the progress is in the treatment. And then also recheck the magnetic strength because things can change if it’s, you know, maybe the sleep pattern has changed or medications have changed or something like that. And so the doctor will recheck the strength of the magnet on a weekly basis.
And during all of the treatments, there’s a technician there with the patient at all times. So that’s kind of an overview and our goal, like I said, after all of this is really change that brain state so that people are in a better position to do things, lifestyle changes that would help maintain the benefits.
So for example, and this is part of what some of the research that I do, using things like meditation, using yoga, using other complementary practices, including behavioral therapies, also using medications, using all the things like exercise, nutrition, lots of things that we know that are good for the brain. But when, when people are in the middle of a deep depression, they’re not able to do those things because they’re just not motivated. They don’t feel good.
So our goal with TMS is to get them out of that state, to a state where they can actually do those things, which will, which are good for the brain, which are good for the mood, and which can help maintain the benefits of the treatment.
I should also mention that there is the possibility of doing additional TMS over time. I mean, it doesn’t have to be just that one course, the most of her patients do in fact, do just one course, but it is possible to have additional treatments. And we know that, from the best data that we have that approximately 62.5% of patients will maintain the benefits, of TMS at a year mark. And this includes people using medications and therapy as well, but altogether, most patients about two thirds of patients will be able to maintain the benefits at the year mark. I mean, that’s just, that’s just an arbitrary time point because that’s just how long that particular study was.
In my own experience, I have lots of patients who don’t need additional courses and they’re able to maintain the benefits of the TMS – ongoing benefits. There are some people that do need additional courses and that’s fine. Most patients who do additional treatments, additional courses of treatment, respond if they respond to the first time.
So there’s about an 85% chance that you’re going to respond again if you respond to the first time and then there was a relapse. So I just want to make clear that that’s not a one-shot thing. It can be done repeatedly, but it may not be necessary to do it repeatedly. Like I said, these lifestyle changes, medications therapy, all of those things can help maintain, we think the benefits of the TMS.
Trent Brown (Host): Yeah, absolutely. Now you talked about the emotions aspect and how you want the person to feel emotions. And in our TMS testimonial videos, which, um, if you’re listening to this and you haven’t seen them, they’re really awesome. And they’re on our website on our TMS page. One of the people that was talking about their experience with TMS talks about all of the emotions that they were suddenly feeling.
And I thought that was just incredible to hear, you know, talking about how he was suddenly feeling like he just needed to cry or he needed to laugh, and he was like, I hadn’t felt that in so long. And that was really incredible to hear.
Sandeep Vaishnavi, MD, PhD: Yeah. I mean, it’s, I certainly hear those kinds of things quite a bit because one of the ways depression can manifest in people is really kind of a flatness, you know, apathy. Nope, nothing. It’s kind of a blank slate and that’s not normal. Obviously, we want emotions. And so we, again, TMS is really trying to get the brain back to the way it should be, uh, and have the proper connections and have the proper, sort of control of the emotions as it should be, but we’re not trying to get rid of the emotions by any means where we might in fact enliven your emotions.
Trent Brown (Host): Yeah. So, let me ask you this for someone listening, what does a candidate for TMS look like? And we can, since we’re talking about depression, we can, we can stick to depression. If that makes it easier.
Sandeep Vaishnavi, MD, PhD: Sure. Sure. So in general, we’re looking for treatment-resistant patients. So what that means is you’ve tried, you know, I’ve had trials of medications, you’ve had therapy trials, but it’s not working or there’s, you know, significant side effects and it’s just not something you can continue doing.
And that’s really more from an insurance point of view because insurance usually covers patients who’ve had several medication failures. So anywhere from, well originally it was really four or more medication failures, but now insurance over time has become better and now we have some insurance coverage after three failures or even two failures.
So that’s more from the insurance point of view. From a clinical point of view, in terms of FDA clearance and in terms of guidelines from the American Psychiatric Association, for example, or the Clinical TMS Society, what they recommend is that TMS can be used even after one failure of medications. So it can be done earlier in the course, but oftentimes what we see is we see patients, who’ve tried multiple, multiple medications. They’ve not done well with them. They want to try a whole different kind of modality, a whole different kind of treatment. And they come to us for that. And we can certainly have great success with patients who’ve had multiple medication failures.
In fact, TMS is much more potent than just trying more medications. So I’ll give you some numbers kind of to back that up.
So, the best data that we have from real world evidence studies is that approximately two-thirds of patients who fall into this category of treatment-resistant depression, about two-thirds will show significant improvement in their symptoms with TMS. And when I say significant, I mean, at least a 50% improvement or greater. So, that’s huge. That’s pretty incredible if you think about it. So these are patients, who’ve tried many, many meds, oftentimes medications, and they’ve just not done well. And here we have a whole different treatment platform that you have a two-thirds chance that you’re going to have clinically significant benefits.
So, that’s one data point.
The other thing to think about is that among these patients, about a third of them can go all the way into remission, meaning we’re able to get rid of the depression entirely or almost entirely. And we really do want to try to get people into remission because the chances of relapse go down as you get into remission.
So we really would like to do that.
And another way, a third data point. Another way to think about this is compared to more medication trials. Your chances of going into remission are four to five fold, greater four to five times greater with TMS compared to just more medication trials.
So it is a really, really potent technology. It’s really applied state-of-the-art neuroscience combined with state-of-the-art technology. So really two very potent things fuse together. And that’s what TMS really is.
Trent Brown (Host): Yeah, that’s awesome to hear. So, we’ve talked about the benefits – there seemed to be quite a few. I’m sure if someone listening to this is probably thinking, you know, what does it feel like when it’s going on and afterwards, and are there any side effects.
Sandeep Vaishnavi, MD, PhD: Sure. Sure. So the way it feels is really, if you think about it, imagine you have two magnets and you put them together, you’ll feel a force, right? So there’s a force from the magnetic coil on your head. So there’s really a tapping sensation. So like someone is knocking on your head or tapping on your head and thats something that can be uncomfortable at least initially at the treatment site. And in some cases that can potentially exacerbate headaches, especially tension-type headaches. I should mention that those are the top two side effects of TMS. It’s really discomfort at the treatment site. But usually, in clinical studies, the vast majority of people will find that those symptoms of side effects go away as the brain gets used to it – as it adjusts to it.
So typically in my experience, after a few sessions, after a week or so, things are a lot better. It’s much more tolerable and people don’t really have that discomfort that they may have had initially. In fact, studies show that there’s only a 2% dropout rate for TMS. So, you know, 98% of people are able to get through the entire treatment course.
So it’s a very tolerable treatment, but there is that initial getting used to it, that tapping sensation.
The other thing to mention is that it’s not like you’re going to have this for the entire 20 minutes, that tapping it’s actually only up for a fraction of that time. So depending on. Type of TMS we use – we have two types of TMS, by the way, at MindPath, we have sort of, what’s called the figure of eight coil, which is the standard TMS, and the H coil, which is a different version ot deep TMS.
Regardless of which machine is used, what we do is that the actual treatment, the tapping is, is just going to be a few seconds and then there’s a pause for a longer period of time and then there’s, again, the treatment for a few seconds and then a pause for a longer period of time.
So to make this more concrete for the trigger of eight coil, the neuro star machine that we have. It’s four seconds of actual treatment, the tapping that you will feel on your head and then 11 seconds of nothing, and then four seconds of tapping again, and then 11 seconds of nothing and it goes back and forth for approximately 20 minutes.
With the Brainsway device, which is the H coil or deep TMS, that is only two seconds of tapping and 20 seconds of nothing and then two seconds of tapping 20 seconds of nothing and it just alternates for approximately 20 minutes.
So, that’s something that, you know, once you’re in the chair, we would explain all of this in great detail to you, make you comfortable. We would actually first do just one pulse at a time to get you used to it and to actually figure out what’s the best strength of the magnet for you as an individual and the best location. Once we do that, then we kind of walk you through the actual treatment. So there, there really should be no surprises there. Everything’s going to be walked through very carefully, very systematically, and we’ll be there. Of course, the doctor and the technician to make sure that you’re comfortable and you’re getting used to it. So, you know, we generally find that people get pretty used to it quite.
Trent Brown (Host): Yeah, good to hear. That is good to hear. So we talked about this a little bit earlier, you talked about the research that other people are doing and research that you’ve worked on. Can you talk about some research on this that you’re excited about or that you’ve worked on, so people can kind of get an idea of what’s going on with it?
Sandeep Vaishnavi, MD, PhD: Yeah, absolutely. So, we’ve talked about how well TMS works, and really it is very potent, but obviously, it can be improved. So our goal, our research goal is to really optimize outcomes, treatment outcomes. I’m just going to put this in perspective, our outcomes at MindPath are already higher than the national average. I was mentioning about two-thirds of patients get significant improvement – our numbers are more like 90% get significant impact. And in terms of remission, we talked about maybe a third of patients have remission and nationwide. Our remission rates are more between 50 and 60%. So we already have, you know, good results, but there, there can always be greater improvement. And we were looking at improvement at different time points, like for example, First of all, it would be great to be able to predict which patients will get improvement and which patients won’t get improvement. That way we would be able to kind of really use this as a personalized treatment for the right person at the right time in their disease course.
So that’s one line of research that, that I’ve been working on. And another line of research is to maybe do something to supplement the TMS, such as yoga or meditation or other modalities like that. And to see if we can get better results, optimize our results.
And then the third line is after treatment, how can we best maintain the benefits of the treatment? So there we’ve done projects for all three of those aspects. And if I, if you want, I can go into some detail about all three of those types of research.
Trent Brown (Host): Yeah. Yeah, absolutely. Let’s hear it.
Sandeep Vaishnavi, MD, PhD: Sure. So one of the things that we’d really like to have is a biomarker, a way to know which patient individual patient is going to respond, which patient may not respond.
Like I said, most patients will respond, but not everyone. So it would be great to be able to say to an individual patient; “okay, you’re quite likely to respond. So this is s great possible treatment for you. Let’s move forward with this” or alternatively to a patient; “Well, you know what? You’ve got this biomarker that suggests you may not be such a great responder, perhaps that’s not the best route right now for you. Let’s try something else.”
So that’s really where we want to go. And this is by the way, it’s not a problem just in TMS or just in psychiatry or neurology, this is all medicine ultimately, where we’re really trying to move towards personalized medicine or precision medicine. So it’s more individualized because most data that we have now from any modality, it could be medications could be therapy, behavioral therapy could be TMS – they’re really based on group studies, right? A lot of people are in a group. We can have a comparison group that didn’t get the treatment or has a placebo, for example, and then we compare the two groups and we can say; “oh yeah, this particular treatment seemed to be on average, much better than the placebo”.
And that’s how medications, for example, are brought to market FDA, approves them. So that’s, that’s important and that’s great. However, that doesn’t get at the individual variability and what we’ve learned in medicine is that people are incredibly variable. There’s a lot of variability in genetics. Obviously, there’s variability in the environmental experiences at the brain level. All our brains are incredibly unique, very, very different. And so one particular medication or one particular treatment may help. X number of patients, but it may not help you individually.
So that’s the whole goal here is to try to kind of get more individualized treatments.
And so one way, one kind of biomarker would be to use a cognitive biomarker, basically, a kind of cognitive test to see if we can maybe help predict outcomes. And so what – in our research, what we’ve looked at is a certain cognitive tests. Like for example, there’s something called the, symbol digit coding tests, or it’s a speed of processing tests where basically it’s a very simple test where you match a symbol to a number, and there’s a key right in front of you. So it’s not a memory test. It’s right there in front of you. The goal is that you’re given certain symbols and you have to actually type in the corresponding number as quickly as possible and as accurately as possible.
So it’s a speed of processing. It’s basically something that we know is quite a sensitive test in depression. In fact, there are some antidepressants, particularly Trintellix that specifically have shown benefit for the speed of processing tests. But our goal was to use this test to see if we can help predict Atkinson TMS. So that’s one thing we’ve done. Then another test that can be used is what’s called a perception of emotions test.
So here, the concept is we show facial expressions, different facial expressions on the screen, and the patient has to basically categorize those expressions properly as quickly as possible. So for example, it could be a sad face. It could be a happy face, could be an angry face, could be a surprised face.
All of those of different facial expressions and what we know, in depression, is that patients with depression tend to be faster with negative emotional expression faces than positive emotional expression faces. Whereas people who don’t have depression, they’re usually faster with a positive expression.
So we could utilize that, that knowledge, that piece of information to design a cognitive biomarker and try to figure out, you know, which patients may actually respond better with TMS. And so what we found just to give an example to make this more concrete, what we found, in one of the studies that we did, is that people who actually have more of a negative facial bias.
In other words, depression patients who are much faster than others, in terms of responding to negative facial expressions, those patients tend to do better with TMS. So TMS actually really kind of turns that around in a very significant way. So that’s just an example of the kind of predictive biomarkers.
Then moving to the actual optimization of treatment outcomes. We have looked at a particular kind of breathing yoga called sky S-K-Y, which is Sudarshan Kriya yoga. And it’s rhythmic breathing yoga practice. And the reason we study that is that there’s actually a number of studies over the years, approximately 70 or more studies now that have shown benefits off sky practice for all kinds of different things, including for anxiety, for depression, as well as for decreasing cortisol levels in your blood and even genetic and epigenetic.
So lots of reasons that sky can very powerfully improve your body and your brain. So, we utilize the sky as a supplement to treatment with TMS and to see if we could optimize the outcomes of the treatment. So, and then in terms of long-term treatment outcomes. We’ve just finished a study where we use something called CES, which is cranial electrotherapy stimulation. So it’s a take home, mild electrical stimulator. And that’s actually, this is a kind of technology that’s already FDA cleared for insomnia, anxiety, and depression. However, it doesn’t work nearly as well as TMS in terms of treatment for depression. What we did is we actually combine the two. Plus cranial ultra therapy stimulation to see if we can help maintain the benefits of the TMS for longer periods of time and we, that’s what we shown with with the study that we just did, which we have just submitted to the International Brain Simulation Conference that’s coming up this year.
So just to give you a flavor of the different types of studies that we’re doing, our goal at MindPath, obviously to get the best outcomes possible for patients, but we’re also trying to push the field forward, you know, let’s, let’s move the science forward, move the needle forward. So then we can learn more and more about how to get best outcomes for everybody.
Trent Brown (Host): Yeah, absolutely. That is very interesting information. Thank you for sharing. So I guess my last question because I’m not perfect, I always like to ask this, is there anything about TMS that I’ve missed that you would like to tell people.
Sandeep Vaishnavi, MD, PhD: I think we’ve covered almost everything about TMS. I would just add that, I would really think about this as a next generation of treatment for patients. So this is, State-of-the-art technology for patients and as I said, it’s state-of-the-art technology and state-of-the-art brain science and it’s really a potent combination.
And really the way TMS works is kind of the same technology in a way that we use now for almost everything in our society, such as; cell phones or wifi or computers, or, you know, anything that we utilize. Technologically pretty much utilizes the electromagnetic fields and TMS is based on the electromagnetic field.
So you can imagine that it’s really a potent technology, just like our cell phones are really a potent technology or computers are a potent technology. So it’s really something which is new and state-of-the-art for our field for psychiatry. And I think that we’re going to be utilizing things similar to that, even other things in the future.
I mean, so this is just the beginning of neuromodulation, I think in psychiatry and neurology, there are all kinds of different technologies that are being assessed right now, anywhere from ultrasound technologies we can utilize on the brain. To even using certain wavelengths of light to actually change things in the brain. Believe it or not, circuits in the brain as well as using mild electrical stimulation, there are all kinds of things that kind of fall into this neuromodulation category.
So as I said, it’s really just, it’s a very exciting time. We’re just at the beginning of this. And TMS is luckily very potent and it’s available now. And I would encourage people who are listening to, to really think about it and try to take advantage of this really incredible advanced and techniques.
Trent Brown (Host): Absolutely. Yeah. Well, thank you so much. So, so if anybody is curious to learn more about TMS or if TMS may be right for you, you can go to this link here. Dr. Vaishnavi, thank you so much, this was really interesting.
Sandeep Vaishnavi, MD, PhD: Absolutely. My pleasure. Thank you.
Trent Brown (Host): All right. Thank you all for listening.