Transcranial magnetic stimulation (TMS)

Transcranial magnetic stimulation is a non-invasive method of modulating brain activity. Short magnetic pulses are released by a butterfly-like coil, which passes non-invasively and painlessly through the intact skull cap and into the outer brain regions. On the basis of electromagnetic induction, they cause a lasting and painless change in neuronal activity. For example, impulses emitted by the motor region of the brain can cause muscular contractions of the hand.

If pulses are emitted over a certain area over several sessions, this may also have long-term effects with respect to neuronal activity. TMS attempts to excite sub-active regions or to inhibit hyperactive regions. On this basis, tms is successfully used as an (alternative) form of therapy for various neurological and psychological disorders (example, in depression, schizophrenia, post-stroke rehabilitation, pain, etc.).

When the pulse is delivered, there is a loud popping sound, which is caused by the magnetic field. Pulse delivery may be perceived as a slight knock depending on the strength of the pulse and the sensitivity of the respective patient. Depending on the stimulated area, some body muscles may also be stimulated directly or indirectly. As described, the muscles of the hand can be stimulated to contract, while the stimulation on the front of the head can also stimulate certain facial muscles such that the muscles of the jaw can be stimulated.

TMS is a safe and low side effect method that has been used for many years in diagnosis and therapy.

The method is:

  • Non invasive
  • Without use of anesthesia (the patient is awake)
  • Non-pharmacological (without the typical side effects of drugs)
  • Painless and widely tolerated

The contraindications (exclusion criteria) of TMS are:

  • Presence of metal parts in the head (implants, splinters of metal, ...)
  • Epilepsy in personal prehistory and possibly also family
  • Pacemaker
  • Pregnancy

Side effects that may occur:


  • Headache or blow
  • Short of discomfort, dizziness, being dazed
  • Temporary change of hearing threshold


  • Short term, not because of the RTMS but by a situation of stress caused unconsciously (syncope)

Extremely rare:

  • Epileptic crisis (since the introduction of the safety guidelines by Wassermann (2006) and Rossi (2009) almost excluded).


Many of the typical side effects of pharmacological drugs do not occur in TMS.