TMS Therapy

What is TMS Therapy?

Transcranial Magnetic Stimulation (TMS) is a non-invasive brain stimulation technique that uses magnetic pulses to modulate neural activity in targeted brain regions. A treatment coil is placed against the scalp, delivering brief magnetic pulses that pass through the skull and influence the electrical activity of neurons beneath.

TMS is approved by NICE (National Institute for Health and Care Excellence) for treating depression and OCD, and has FDA clearance for several additional conditions. TMS acts directly on the brain circuits involved in your condition through precise magnetic pulses, and unlike ECT, it requires no anaesthesia and has minimal side effects.

At Cosmos Healthcare, we combine TMS with QEEG brain mapping to ensure precise targeting. When we can see which brain regions show abnormal activity, we can direct TMS to exactly where it's needed most.

How TMS Works

TMS uses the principle of electromagnetic induction—the same principle behind electric motors and transformers. When an electrical current passes through the treatment coil, it generates a magnetic field. This magnetic field passes through your scalp and skull without any sensation, then induces small electrical currents in the brain tissue beneath.

These induced currents are sufficient to activate or inhibit neurons in the targeted region. Depending on the frequency and pattern of stimulation, TMS can either increase or decrease activity in specific brain areas:

• High-frequency TMS (≥5 Hz): Generally increases neural activity in the targeted region
• Low-frequency TMS (≤1 Hz): Generally decreases neural activity
• Theta burst stimulation: A newer protocol that achieves results in shorter treatment sessions

By repeatedly stimulating the same brain region over multiple sessions, TMS can produce lasting changes in neural activity patterns—essentially helping the brain to "reset" dysfunctional circuits.

The Clinical Framework

Every deployment operates four coordinated layers working in perfect harmony:

Standardised Excellence

Our clinical framework ensures that every TMS treatment follows a reproducible method for detecting network dysregulation and translating findings into personalised care plans. The system integrates 32 critical analyses, combining established neurophysiological biomarkers with translational checks, ensuring measured change becomes functional change in daily life.

NeuroMap® classifies neurofunctional state using core EEG biomarkers and functional criteria, then QPAN® translates this into stepwise care plans and rolling risk logs. When family reports, video observations, and clinician notes arrive, they're integrated with qEEG data to update priorities dynamically. The focus remains on resolving the network state affecting function.

Medico-Legal Defensibility

Each component is designed for clinical reproducibility and medico-legal defensibility. Our proprietary NeuroMap® system assists with result interpretation but never alters the underlying rules that generate recommendations. Same inputs consistently produce same outputs—critical for audit trails and regulatory scrutiny.

What to Expect

Before Treatment

You'll have an initial consultation where we review your medical history, discuss your symptoms, and determine whether TMS is appropriate for you. If we recommend QEEG assessment, this will be completed before treatment begins to guide targeting.

During Treatment

TMS sessions typically last varies depending on the protocol used. You'll sit in a comfortable chair while the treatment coil is positioned against your head. You'll hear clicking sounds and feel a tapping sensation on your scalp—this is normal and not painful.

You remain fully awake throughout treatment and can return to normal activities immediately afterwards. There's no sedation, no recovery time, and you can drive yourself home.

Treatment Course

A typical TMS treatment course involves 20-30 sessions over 4-a treatment period, usually delivered daily (Monday to Friday). Some conditions respond to shorter or longer courses, which we'll discuss during your consultation.

After Treatment

Many patients notice gradual improvement over the course of treatment, with effects continuing to develop over time after completing the course. We'll schedule follow-up appointments to monitor your progress and determine whether maintenance sessions would be beneficial.

Conditions We Treat with TMS

Depression & Anxiety

NICE-approved for treatment-resistant depression. TMS targets the prefrontal cortex to regulate mood circuits that may be underactive in depression. Learn more about TMS for depression.

Obsessive-Compulsive Disorder

NICE-approved for treatment-resistant OCD. TMS targets the brain circuits involved in obsessive thoughts and compulsive behaviours through QEEG-guided precision targeting. Learn more about TMS for OCD.

Autism, ADHD & Learning Difficulties

TMS as part of a multimodal programme to support attention, communication, and daily functioning in neurodevelopmental conditions. Learn more about neurodevelopmental support.

Addiction

TMS targeting reward circuits and impulse control regions as part of comprehensive addiction treatment programmes. Learn more about addiction treatment.

Safety & Side Effects

TMS is considered a safe treatment with an excellent safety profile established over decades of clinical use and research. The most common side effects are:

• Scalp discomfort: Mild tenderness at the stimulation site, usually diminishing over the first few sessions
• Headache: Some patients experience mild headaches after treatment, typically responsive to over-the-counter pain relief
• Facial twitching: The magnetic pulses may cause muscles in the face to twitch during treatment—this is normal and not harmful

The most serious potential risk is seizure, but this is extremely rare (less than 0.1% of patients) and typically only occurs in individuals with pre-existing seizure disorders or other risk factors. We screen all patients carefully before treatment to identify and exclude those at elevated risk.

TMS is not suitable for patients with:

• Metal implants in or near the head (excluding dental work)
• Cochlear implants
• Implanted stimulators or pumps
• History of seizures or epilepsy
• Certain other medical conditions (discussed during consultation)