Repetitive Transcranial Magnetic Stimulation (rTMS)

Repetitive Transcranial Magnetic Stimulation (rTMS) is a safe, non-invasive form of brain stimulation. It has been approved by Health Canada for the treatment of depression in adults.  While rTMS is currently only approved for depression, the Temerty Centre for Therapeutic Brain Intervention is running several studies investigating the use of rTMS to treat autism spectrum disorders, schizophrenia spectrum disorder, obsessive-compulsive disorder, and substance use disorders. 

Research shows:

• About 50% of patients experience a significant improvement of symptoms – which is so important, as patients who get this treatment have not responded to first-line treatments, such as medication and therapy.  
• About 30% of patients achieve remission where their symptoms are largely resolved. 

While rTMS is currently only approved for depression, the Temerty Centre for Therapeutic Brain Interventions is running several studies investigating the use of rTMS to treat autism spectrum disorders, schizophrenia spectrum disorder, obsessive-compulsive disorder, and substance use disorders.

rTMS uses magnetic pulses to stimulate specific brain regions involved in depression. These pulses activate underactive brain circuits, help brain cells communicate more effectively, and support neuroplasticity—the brain’s ability to rewire itself—ultimately helping to restore healthier patterns of brain activity and reduce symptoms of depression.                                                                                                                                                                          

A typical course of rTMS consists of five treatments per week, for 30 sessions over six weeks.

Sessions can range in the length of treatment time depending on the protocol you are receiving.

Your provider will discuss the specific details for your treatment, while an rTMS technician will administer your treatments.                                                                                                                                                                                                                                     

The treatment takes place in a dedicated treatment room, where you will be seated in a chair.

rTMS is non-invasive and does not require anesthesia. Patients remain awake and can return to normal activities immediately after treatment. 

A magnetic coil is positioned in a device that the technician can move to rest comfortably in the correct location on your head.

You will be given earplugs to wear during the treatment. The rTMS technician will monitor your comfort and operate the machine throughout.                                                                                                                                                                                                                          

rTMS is a safe and well-tolerated treatment that may cause mild side effects. The most common side effects include mild headache and scalp discomfort.

In very rare cases (less than 1 in 10,000 patients), rTMS can cause a seizure. 

A physician is on site at all times when people are receiving treatment in case of an emergency.                                                                                                                                                                                                                                                           

rTMS is often described as being a 'tapping or woodpecker-like sensation,' or 'a stinging sensation' on the head. Although it can be initially uncomfortable for some patients, the majority of people adjust to the sensation after a few treatments. 

Only a very small percentage of people cannot tolerate the treatment and, if that is the case, an alternative type of protocol can be used. 

Watch this segment of TVO's The Rundown to see it in action

Before receiving your first treatment, a physician will determine your motor threshold. This is a procedure that involves the physician placing the magnetic coil on top of your head, where it will deliver single pulses every few seconds, in order to stimulate your motor cortex. This will cause your hand muscles to twitch. The twitching is a visual indication of your brain excitability, which is needed to determine your optimal stimulation intensity for treatment.

CAMH is a recognized global leader in brain stimulation research, clinical care, and system implementation, particularly in rTMS and other forms of TMS.                                                                                                                             

CAMH is home to Canada’s largest brain stimulation program, integrating rTMS, ECT, and emerging neuromodulation therapies into care for people with complex and treatment-resistant conditions.  

CAMH has played a key role in translating research into real-world clinical practice, ensuring that patients benefit from the latest advances in brain stimulation. 

CAMH has been training physicians from across the Globe to deliver rTMS since 2014. 

Through its combined research, clinical, and system leadership, CAMH is helping make brain-based treatments more targeted, non-invasive, and accessible as part of modern mental health care. 

To learn more about brain stimulation research at CAMH, visit the Temerty Centre for Therapeutic Brain Intervention webpages.