As the very first patient treated at the Tysons Corner, Va., facility, which opened in December, Curtis paid only $3,000 because the center needed a test patient to meet the requirements of the device manufacturer. The fee is generally about $10,000, but officials say they work with patients who can't afford that. Founders of the center compare rTMS' potential to that of the now-ubiquitous laser eye clinics; they aim to open a chain of centers nationally that will take walk-ins and accept referrals from physicians. Walk-in patients without a doctor referral would be screened by the center's medical director to determine if they are in fact appropriate candidates for rTMS treatment.
"We looked at the Lasik model and said, 'Can we do this with depression? Can we do this with TMS?' " said Bill Leonard, president of the company.
During a treatment, a patient sits in a chair like one in a dentist's office while an electromagnetic coil is placed against her head. The machine sends four seconds of magnetic pulses into the brain in 26-second intervals, making a woodpecker-like tapping noise. The whole procedure takes about 40 minutes and is monitored by a technician. Patients say it does not hurt. Studies have shown that side effects are few and generally minor, such as headaches and scalp irritations.
Singh said rTMS works by having the pulses stimulate a region of the brain that helps control mood; researchers say the pulses help depression by activating the release of neurotransmitters such as serotonin, norepinephrine and dopamine. (Singh, who owns two psychiatry practices in the region, says he does not have an investment interest in TMS NeuroHealth.)
The use of rTMS for altering mood or affecting the brain has been studied since at least the early 1990s. After reviewing data from a study of 301 patients, the FDA cleared the device in 2008 for the treatment of major depression in adults who had failed to improve after at least one round of drug therapy.