iTBS vs TMS: What is the Difference?

Nov 19, 2021

Transcranial Magnetic Stimulation (TMS) therapy has become increasingly popular in the treatment of mental illnesses over the past decade. Because of its advantages over other treatments for depression, such as medications and electroconvulsive therapy, it has become an amazing tool in the arsenal of a doctor’s potential prescriptions.

If you are not familiar with TMS, it is a therapeutic approach towards treating mental illnesses by stimulating areas of the brain that are associated with mood. When looking at an electroencephalography (EEG) report, we can see essentially a heat map of the brain — representing electric activity happening in neurons. In people with depression, there are regions of the brain that are typically weak and underactive.

By finding out which parts of the brain are underactive (or overactive) we can re-balance them with electro-magnetic frequencies using a TMS machine. And, by balancing out activity in parts of the brain, we can reduce symptoms of mental illnesses, helping the patient go into remission.

So, is intermittent theta burst stimulation (iTBS) the same as TMS? Yes, and no.

Theta burst stimulation is essentially a new protocol of TMS that allows different frequencies of magnetic stimulation, allowing for a shorter treatment time and potentially better treatment results for a range of different illnesses.

How do TMS and TBS differ?

Theta burst stimulation is a newer form of transcranial magnetic stimulation that can be delivered in 3 minutes rather than 30-45 minutes with rTMS.

The two popular theta burst stimulation protocols are intermittent theta burst stimulation and continuous theta burst stimulation:

  • Intermittent theta burst stimulation (iTBS) is an excitatory stimulation that essentially activates neurons that are underactive, such as seen in depression.
  • Continuous theta burst stimulation (cTBS) is an inhibitory stimulation that is used to decrease neuronal activity in overactive parts of the brain, such as seen in anxiety or PTSD.

The difference between these two types of theta burst protocols and normal repetitive transcranial magnetic stimulation is the frequency of electromagnetic stimulation.

Standard TMS typically runs at 10 Hz. And, the typical theta burst stimulation protocols run at 50 Hz every 200 ms. With iTBS, this stimulation runs for 2 seconds on, and 8 seconds off. Typically, both run for 600 pulses within 3 minutes. With cTBS, that stimulation is continuous and actually calms parts of the brain.

If you’d like to watch an explainer video that discusses these differences and benefits of TBS over TMS, listen to Dr. Robert McMullen explain on MagVenture’s Youtube video:

Which Brain Stimulation Therapy is Best For You?

While theta burst stimulation is an incredible feat in psychiatry for treating mental illnesses, especially depression, the answer is not so black and white.

As mentioned earlier, an EEG will give the treating doctor a better idea of how one’s brain is activating. With this information, a protocol can be designed to treat a person accordingly.

Recent publishings on Stanford’s Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT) study may indicate that iTBs may become the more dominant brain stimulation method in the future. But, more research is needed to determine if this is going to be true.

And for now, TMS Centers like Brain Center TMS are making due with the evidence we currently have — changing the lives of many with treatment-resistant depression.

If treatment session time is an issue, then iTBS may be of benefit due to its ability to have an effect in nearly one-tenth of the time it takes to treat a patient with standard TMS.

Get Theta Burst Stimulation in San Diego, CA

If you or someone you love is struggling with treatment-resistant depression, do not give up hope. Thanks to state-of-the-art technologies in psychiatry such as TMS and TBS, there are options for depression when medication doesn’t work.

Give Brain Center TMS a call to get a free consultation to see if TMS or TBS is right for you.

Dial 619-419-0901 to talk to a TMS specialist today!

Considering TMS Treatment? Schedule a Consultation!

Tired of the results you’re getting from your standard treatment? Transcranial Magnetic Stimulation may be able to increase your chances of long-term remission, reducing your symptoms and allowing you to live a more joyful life.

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