Deep TMS vs rTMS: What’s the difference?


What’s the difference between Deep TMS and rTMS?

Our office offers both Deep TMS and conventional rTMS.


Deep TMS

Brainsway Deep TMS

Deep TMS was cleared by the FDA in 2013 as a safe and effective treatment for depression patients, especially those who tried one or more medication types without improving. In 2018 it was approved for OCD. This system is made by Brainsway and uses an H-coil, which allows for a deeper and wider stimulation of the brain. The H1 coil stimulates 1.7cm beneath the surface of the skull over a large area reaching 17cm3 of neuronal tissue. Some H coils, such as the H7 can reach up to at depths up to 4cm to target the anterior cingulate cortex. Studies have shown that deep brain structures have more connections with the reward system, so deep stimulation is highly effective.

Deep TMS sessions last 20 minutes only – almost half the length of rTMS treatments, which last 37 minutes.

There are numerous current clinical trials worldwide to study its effectiveness in treating other disorders and medical conditions. Our office has four Brainsway systems with four different H coils.



Neurostar TMS

rTMS was first FDA approved in the US in 2008 for use with depressed patients who had not received satisfactory benefit from one of their medications.

One system is made by Neuronetics Inc. and is referred to as the Neurostar TMS Therapy system. This uses a clam shaped Figure-8 coil that is placed over the surface of the scalp and delivers pulses to an approximate depth of 0.7cm below the skull. This is considered to be a more “focal” or a localized area stimulus, and not as deep into the brain as the Brainsway system. We have two Neurostar systems.

The Magstim Air Film coil is another type of figure 8 conventional rTMS device used to treat patients. We have oneMagstim Air Film Coil. The Magtim and Magventure TMS systems did not do a clinical trial to become FDA cleared for depression. They are the “generic” version of the Neurostar system.

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