Quackery Exposed: Transcranial Magnetic Stimulation

What is Transcranial Magnetic Stimulation

Transcranial magnetic stimulation is a procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. TMS is used when other treatments have not been beneficial. 

Treatments that should be tried first:

  • psychotherapy
  • medication

This treatment is performed by delivering repetitive magnetic pulses, so its called repetitive TMS or rTMS. 

During a TMS session, an electromagnetic coil is placed against the patient's scalp near the forehead. The electromagnet delivers a magnetic pulse with no pain. This pulse stimulates the nerve cells in the region of the brain involved with mood control and depression. Its thought to activate regions of the brain that have decreased activity in depression. 

The science behind TMS isn't completely understood. It does seem that it impacts the way the brain is working. It has shown to ease depression symptoms and improve mood. 

It is FDA approved for the following conditions:

  • Obsessive Compulsive Disorder (2018)
  • major depression (2008)
  • migraines (2013)

Side Effects of TMS:

  • Headache
  • scalp discomfort at the site of stimulation
  • Tingling, spasms or twitching of facial muscles
  • Lightheadedness
  • seizures
  • mania
  • Hearing loss if there is no ear protection

Contraindicated for: 

  • people with aneruysm clips or coils
  • people with stents
  • people with implanted stimulators
  • people with implanted electrical devices, such as pacemakers or medication pumps
  • people with electrodes for monitoring brain activity
  • people with cochlear implants
  • people with any magnetic implants
  • people with bullet fragments
  • people with any other metal device or object implanted in the body
  • people with a history of seizures
  • people with other mental health conditions
  • people with brain damage or illness
  • people with frequent or severe headaches

TMS and Autism

ARI Endorses TMS for Autism

The Autism Research Institute endorses research in TMS for autistic people. There have been studies done to see if it is effective to improve social awkwardness. They offer videos on the subject that are about 1 hour long and at the beginning of each one, they ask for donation. They cannot get federal research grants so they beg for money to fund their bogus research. 

What the Science Says


One study was published in the journal Brain Stimulation. This study involved 28 autistic adults in a double blind study. Half of the participants received the treatment and the other half received a placebo treatment. The treatment was given daily on week days for two weeks. The study claims to improve social functioning for the participants. 

The method of data collection was done by the subjects self reporting. There was no science behind the data collection. This is not scientific evidence. This study proves nothing. There were no observation, the participants just reported on daily life. 

There was a literary review of different studies involving TMS and autism in 2018 published in Frontiers in Integrative Neuroscience. They performed a systematic literature search of PubMed, Web of Science, Science Direct, Bielefeld Academic Search and Educational Resources Information Clearinghouse. They found 23 eligible reports. They included 4 case reports, 7 non controlled clinical trials and 12 controlled clinical trials. They concluded that TMS may be useful but the evidence must be regarded inc are as most studies did not adequately control for placebo effects. Little is known regarding the most effective stimulation parameters, targets and schedules. In other words, there is no scientific evidence. 

John Elder Robinson Participated in a TMS Trial




During the 2016 trial at Beth Israel Hospital in Boston, John Elder Robinson participated. John Elder Robinson is a former employee of Autism Speaks. In his book Switched On: A Memoir of Brain Change and Emotional Awakening, he describes his experience with the treatment. He said that the changes made by TMS were life affirming but they were tinged with sadness too because his insights into others emotions showed him how troubled most people's inner lives were. 

"Before TMS, I had fantasized that the emotional cues I was missing in my autism would bring me closer to people. The reality was very different. The signals I now picked up about what my fellow humans were feeling overwhelmed me. They seemed scared, alarmed, worried and even greedy. The beauty I envisioned was nowhere to be found." 

What he was feeling was empathy. Autistics feel empathy deeper than NT.  The doctors who were involved with his treatment says his response was unusually robust. The fact that he was willing to try a treatment to try to change qualities that make him autistic is troubling especially when there is no science to back it up. 



Sources:
https://www.fda.gov/news-events/press-announcements/fda-permits-marketing-transcranial-magnetic-stimulation-treatment-obsessive-compulsive-disorder

https://www.mayoclinic.org/tests-procedures/transcranial-magnetic-stimulation/about/pac-20384625

https://www.brainstimjrnl.com/article/S1935-861X(13)00299-4/fulltext

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6046620/

https://www.autism.org/transcranial-magnetic-stimulation-tms-for-asd-research-updates/

https://www.npr.org/sections/health-shots/2016/07/09/484810552/hope-still-races-ahead-of-evidence-in-magnet-treatment-for-autism


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