Neurofeedback (NF) and Transcranial Magnetic Stimulation (TMS) are innovative brain-based therapies used to treat various mental health disorders. Although they both focus on brain function, they work in very different ways and are preferred treatments for different conditions. Read on to learn more about these treatments and the conditions they are most suited for.
What Is Neurofeedback?
Neurofeedback is a non-invasive and drug-free therapy used as a complementary treatment for conditions such as ADHD, anxiety, depression, and post-traumatic stress disorder (PTSD)..
It falls under the broader category of biofeedback—a method where patients learn to regulate their physiological functions to improve physical and mental health. Neurofeedback uses the patient’s electroencephalogram (EEG) data as feedback to modify the brain’s electrical activity patterns [1].
During a neurofeedback session, you sit comfortably while engaging in a computer-based activity such as playing a game or watching a movie. A technician places electrodes on your scalp to record the electrical activity in your brain. This creates a real-time computer brain map based on responses to your interaction with the screens. This feedback allows mental health professionals to monitor your brainwave patterns. Over time, these patterns provide a guide to modify or train your brain toward healthier states of mind.
How Neurofeedback Works
There are two main types of neurofeedback therapy. One uses EEG and the other uses real-time functional magnetic resonance imaging (fMRI). EEG-based neurofeedback recalibrates brainwaves, while fMRI neurofeedback (less commonly used) recalibrates patterns of brain activity and connections between parts of the brain [2].
Neurofeedback training allows you to adjust your brain activity based on biofeedback, which involves specific brain cortical actions that can influence behavior. This allows you to change your electrical brain activities or brainwave amplitude, frequency, or coherency.
Both forms of neurofeedback therapy allow clinicians to measure altered brain functioning resulting from trauma or other conditions. This provides feedback that helps you learn to self-regulate brain activity to decrease symptoms of anxiety, PTSD, or other conditions.
What Conditions Can Neurofeedback Treat?
Neurofeedback has been used for various purposes for decades. Over time the technology has been refined to target conditions such as anxiety, depression, ADHD, traumatic brain injury, and PTSD.
While the precise mechanisms behind how neurofeedback works remains unproven, there is evidence suggesting it can be effective for patients with certain disorders, even though there is disagreement over exactly how or why it works. Several peer-reviewed studies suggest better data with more patients over time is needed to confirm it is effective for the wide range of disorders it is claimed to treat.
Evidence appears strongest for the use of neurofeedback in ADHD, anxiety disorders, sleep disorders, and traumatic brain injuries. Some studies suggest it can improve cognitive processing speed and executive function.
Neurofeedback is currently viewed as an adjunct therapy rather than a replacement for other treatments, including medication, within multi-modal treatment programs.
What is Transcranial Magnetic Stimulation?
TMS is a non-invasive outpatient procedure that uses electromagnetic pulses to target specific areas of the brain associated with mental health symptoms. During a TMS session, a magnetic coil is placed on the scalp, and the device sends pulses that modulate neural activity, helping to regulate brain activity and alleviate distress. There are two types: repetitive TMS (rTMS) and deep TMS (dTMS), each offering advantages.
Sessions typically last 30-60 minutes and are usually performed five days a week for 4-6 weeks. Patients may feel sensations of tapping and hear pulsating sounds in short bursts. Some patients experience short-lived and mild side effects, including headaches, which typically resolve within a day.
What Conditions Can TMS Treat?
TMS is an FDA-approved treatment for the following mental health conditions
- Major Depressive Disorder: Particularly for moderate to severe depression when other treatments have failed
- Obsessive Compulsive Disorder (OCD)
- Anxious Depression: Depression with co-occurring anxiety disorders
Although not FDA-approved, TMS is being used off-label or researched for:
- Anxiety disorders
- Bipolar disorder
- Post-traumatic Stress Disorder (PTSD)
- Mild cognitive impairment
- Attention Deficit Hyperactivity Disorder (ADHD)
- Migraines
- Personality disorders
While TMS shows promise for these off-label uses, more research is needed to determine efficacy.
When Is TMS Preferred Over NF?
Recent research suggests TMS may be more effective than NF for certain conditions:
Depression
There is strong clinical evidence for TMS as a treatment for depression, particularly in treatment-resistant cases. It is FDA-approved and remission rates exceed 37% [3].
Obsessive Compulsive Disorder
TMS is FDA-approved for OCD treatment. While NF has shown promise for various mental health conditions, TMS has a more established record for treating OCD.
Severe Mental Health Conditions
TMS often provides faster and more significant results for more severe conditions, especially when other treatments have failed.
Cognitive Enhancement
While both therapies can improve cognitive function, TMS shows particular promise in enhancing focus and memory through direct stimulation of specific brain regions.
Key Takeaways
- Both TMS and NF show lasting results, typically between six months to a year, with TMS effects potentially lasting somewhat longer.
- The effectiveness of both TMS and NF can vary depending on individual factors, the specific condition being treated, and the severity of symptoms.
- While TMS can be effective for conditions like depression and OCD, NF holds significant value for treating anxiety, ADHD, and sleep disorders.
- While both TMS and NF show promise, more research is needed to determine their efficacy for different conditions.
- The choice between TMS and NF should be made in consultation with a trained healthcare professional, considering the individual’s needs and treatment goals.
The Harper Clinic Approach to TMS
Before starting TMS, a licensed mental health professional will assess whether it’s the right treatment for you. Harper Clinic offers a simple, 3-step consultation process for patients considering TMS:
- Contact Us – Reach out via text, phone, website contact form, or our direct Vagaro booking system to schedule your consultation.
- Personalized Consultation – Meet with a provider who will review your medical history, discuss your treatment goals, and create a customized care plan tailored to your needs.
- Comprehensive Assessment – Your consultation includes insurance verification, a full medical history review, and an evaluation of past treatment attempts. Depending on your case, your provider may explore alternative or complementary treatments, such as medication, Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), or Eye Movement Desensitization and Reprocessing (EMDR).
If TMS is determined to be a suitable option, your provider will approve you for treatment and schedule your sessions.
Ready to take the next step? Contact Harper Clinic today to see if TMS is right for you!
Sources
[A] Larsen S. and L. Sherlin. 2013. Neurofeedback: An Emerging Technology for Treating Central Nervous System Dysregulation. March 2013. Psychiatric Clinics of North America. 36(1):163-168
[B] Atlas Institute for Veterans and Families. Neurofeedback Therapy
[C] Cao X. et al. Response and Remission Rates Following High-Frequency vs. Low-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) Over Right DLPFC for Treating Major Depressive Disorder (MDD): A Meta-Analysis of Randomized, Double-Blind Trials. Front. Psychiatry, 06 September 2018. Sec. Mood Disorders. Volume 9 – 2018
