TMS: Reversing Depression’s Abnormal Flow of Brain Signals

Major depressive disorder (MDD) is one of the most common mental health issues, affecting millions worldwide. Despite its prevalence and the extensive research on the condition, practitioners only partially understand what goes on in your brain when you have MDD. This is partly why there are so many different antidepressants targeting different chemicals in your brain. They target serotonin, dopamine, norepinephrine or noradrenaline, even an enzyme involved called monamine oxidase, and more.

However, there’s a handful of new research studies that suggest depression may have a connection to the signaling patterns in your brain. The best part is that a treatment already targets these signals in your brain. Before exploring that, you need to understand the basics of neural pathways in your brain.

Your Brain’s Neural Pathways and Depression

Brains work through complex communication between neurons, specialized cells that are your nervous system’s structural and functional units. Collections of neurons together form nerves that send and receive signals throughout your brain and body.

Neurons can transmit messages through electrical and chemical means, creating the network that underlies our bodily functions, movement, cognition, emotion, and behavior. Neurons in your brain can release these chemical messengers, called neurotransmitters, to send signals from one neuron to another.

Because neurotransmitters like serotonin, dopamine, and norepinephrine play a pivotal role in regulating mood, research often links depression to an imbalance of these neurotransmitters. However, it’s not just about disruptions in these chemical levels. It’s also about the direction of signaling patterns in your brain. An irregular flow, especially in your prefrontal cortex and limbic system (areas of your brain), contributes to symptoms of depression. You might experience persistent negative emotions, low energy, or cognitive impairments like the inability to think, concentrate, or make decisions.

Enter an Alternative Depression Treatment

Identifying a method to modulate this abnormal neural activity has been a key focus in developing effective treatments for depression. In 2008, the FDA approved a revolutionary treatment for depression called transcranial magnetic stimulation (TMS). By placing a coil on patients’ scalps and using a device to emit MRI-like electromagnetic pulses, TMS specialists can induce electrical currents along neurons, effectively modulating the neural circuits associated with depression.

This study published in the “Proceedings of the National Academy of Sciences” suggests that Stanford intelligent neuromodulation therapy (SNT or SAINT TMS) induces signal direction changes in two parts of your brain associated with mood and emotion regulation. These two brain regions are your subgenual anterior cingulate cortex (sgACC) and dorsolateral prefrontal cortex (DLPFC). The pre-treatment signaling predicted individuals’:

  • Depression severity
  • Treatment response likelihood
  • Depression symptom relief

The study is groundbreaking not only because it demonstrates TMS effectively treats depression but also because these signaling patterns could be a potential biomarker of MDD that will aid further depression research.

How TMS Works to Reverse Abnormal Brain Signaling

1. TMS Targets Specific Brain Regions

TMS is a highly targeted treatment. In addition to not targeting nonessential parts of your body, it also allows clinicians to focus the treatment on specific brain regions implicated in disorders or illnesses, like depression. For example, providers target the DLPFC and sgACC regions when treating depression, inducing chemical activity and reversing signaling flows.

2. TMS Regulates Neurotransmitter Levels

Studies show TMS can influence the presence of neurotransmitters in a similar way to antidepressants. By helping restore the balance of chemicals like serotonin and dopamine, TMS mitigates the brain imbalances that also contribute to abnormal brain signaling and depressive symptoms.

3. TMS Enhances Connectivity

Researchers find that TMS also induces changes like synaptic plasticity, the brain’s ability to “heal” and form new neural connections. Brain plasticity is why people who have suffered an injury or trauma, like a stroke, can learn to walk or talk again.

By encouraging synaptic plasticity, TMS fosters increased connections in your brain, promoting a more harmonious neural network. This plasticity and connectivity promote positive changes in neural pathways associated with depression, which improves mood, cognitive function, and brain signal flow.

What TMS Treatment Actually Looks Like

Whether you understood all the scientific jargon above or not, the bottom line is that TMS can help. And it’s not half as challenging as trying to understand complex neuroscience. Once you have your initial consultation, you’ll have a treatment plan for either:

Standard TMS: You will have one daily session for up to eight weeks. After the first appointment, the sessions are relatively quick; patients can often fit them around their workday.


Accelerated TMS: You will have up to 10 sessions daily for a week or two. Because of your many sessions, you would be at the clinic nearly all day during treatment. While initially more time-consuming, it can provide more rapid relief for severe cases.

Regardless of your treatment plan, every session will be in a relaxing outpatient clinic environment. You can sit back in a chair, watch a movie, or listen to music. You will have a friendly TMS technician who will oversee your session (read more about what they do here), and then you’re free to drive home and resume your daily activities.

If you are interested in alleviating your depression, ongoing research continues to find TMS is one of the favorable treatments. Directly influencing neural signaling pathways and neurotransmitter levels, TMS is a promising therapeutic option, especially for anyone suffering from treatment-resistant depression (TRD). Speak to a provider about your TMS treatment options today.