Dementia is one of the fastest-growing global health concerns, predicted to affect 152 million people by 2050. As there is currently no cure, the search for effective treatments that can slow or reverse brain damage is of increasing urgency. One promising approach is transcranial magnetic stimulation (TMS), a non-invasive technique gaining attention for its potential in both diagnosing and treating dementia. In this article, we’ll dive into how TMS works, its role in dementia care, the scientific evidence supporting its use, and its safety for dementia patients.
What Is Dementia?
Dementia is not a single disease but a syndrome—a collection of symptoms resulting from brain damage caused by various underlying conditions. These symptoms include memory loss, confusion, difficulty with communication, and changes in behavior.
There are over 50 types of dementia, with the most common being:
- Alzheimer’s disease
- Vascular dementia
- Dementia with Lewy bodies
- Frontotemporal dementia
- Parkinson’s disease dementia
Each type affects the brain differently, leading to distinct patterns of symptoms and progression. However, underlying all types is brain atrophy, which refers to the loss of neurons and the connections between them, resulting in a shrinkage of the brain over time.
What Is TMS?
Transcranial Magnetic Stimulation (TMS) is a non-invasive technique that uses brief magnetic pulses to stimulate specific brain areas. A device is placed on the scalp, delivering these pulses painlessly through the skull to the brain tissue underneath.
These pulses change the electrical charges of neurons, either making them more likely to fire or inhibiting them. Depending on the type and frequency of pulses, TMS can either increase or decrease neural activity. The therapeutic effects of TMS depend on which brain region it targets and whether it stimulates or inhibits activity.
TMS is an FDA-approved treatment for major depressive disorder (MDD), obsessive-compulsive disorder (OCD), headaches, and substance abuse disorders. It’s not approved for dementia but can be used off-label, meaning patients can receive TMS if a clinician believes there is strong evidence to support its use.
How TMS May Support Dementia Treatment
How It Works: Boosting Brain Function
TMS influences the brain in three main ways:
- Increasing cortical excitability – In dementia, neurons may become less responsive, impairing communication within the brain. TMS may help by sending stimulating pulses that "wake up" these areas, increasing activity and potentially restoring some of the lost function.
- Promoting neuroplasticity – Neuroplasticity is the brain’s ability to form new connections or reorganize itself after damage. When TMS is delivered repeatedly over time (known as repetitive TMS or rTMS), it can encourage the growth of new connections between neurones (known as synapses), helping to rebuild circuits involved in cognition.
- Stimulating neurogenesis – Neurogenesis is the growth of new neurons, helping to restore function in brain areas that have atrophied in dementia. TMS stimulates the release of growth factors, which are molecules that are crucial for neurogenesis.
Scientists are still learning how TMS works in the brain and how it helps people with dementia. Early research shows promising results, with TMS working best when combined with activities like memory exercises or brain training. These activities help the brain take advantage of the neuroplastic effects of TMS and encourage learning.
TMS in Different Types of Dementia
Alzheimer’s Disease
Alzheimer’s is the most common form of dementia, characterized by memory loss, disorientation, and eventually, loss of independence. It’s linked to abnormal buildups of proteins in and around neurones—specifically, amyloid plaques and tau tangles. This causes brain cells to die, resulting in atrophy.
Alzheimer’s has been most researched when it comes to TMS for dementia. Studies have found that rTMS has a significant positive effect on reducing Alzheimer’s symptoms. In a clinical trial, rTMS combined with cognitive training led to a substantial improvement in memory and language skills in Alzheimer’s patients six weeks following treatment. The treatment showed a stronger therapeutic effect than the typical results seen with acetylcholinesterase inhibitors (AChEIs), which are a first-line therapy for the disease.
Dementia with Lewy Bodies (DLB)
DLB involves the build-up of abnormal proteins called Lewy Bodies between neurones, disrupting cell-to-cell communication in the brain. Characterizing symptoms include problems with attention, vision, and movement, as well as mood changes and hallucinations.
Only one study to date has investigated TMS for DLB. While the researchers didn’t measure changes in cognitive function, patients with DLB had significantly improved depression following TMS. The researchers concluded that TMS was “safe and effective” for DLB patients with treatment-resistant depression.
Vascular Dementia
Vascular dementia is the second most common form of dementia, which is caused by reduced blood flow to the brain. With a deficiency in oxygen and nutrients from the blood, neurons become damaged and die off.
TMS not only stimulates neuroplasticity but can also increase blood flow to target brain regions, making it a promising treatment option for this type of dementia. Several animal studies show TMS can be therapeutic in preventing and treating vascular dementia. However, there has only been one small study on human patients to date. In this trial, seven patients had rTMS over their DLPFC. They showed improved speed of performing tasks, problem-solving ability, and memory following treatment.
Parkinson’s Disease Dementia (PDD)
PDD develops in people with Parkinson’s disease and involves both a decline in motor function as well as cognition. PD is caused by a loss of cells that produce the chemical messenger dopamine, which plays a key role in movement, motivation, and cognitive functions. Research shows TMS increases the release of dopamine, which may be a valuable mechanism in PDD treatment.
In a clinical trial, PDD patients received high-frequency rTMS over their motor cortex. While there was no significant change in dementia symptoms, the patients’ movement skills significantly improved.
Diagnosing Dementia with TMS
TMS doesn't directly diagnose dementia but offers helpful insights into brain function that support diagnosis. It measures how the brain responds to magnetic pulses, revealing changes in cortical excitability and neural circuits often seen in dementia.
Here's how TMS can help:
- Cortical excitability: TMS can detect changes in how easily neurons fire.
- Dementia type differentiation: Different dementia types show unique patterns of brain activity, which TMS can help identify.
- Neurotransmitter function: TMS can assess the function of key neurotransmitter systems like GABA, glutamate, and acetylcholine, which are affected in dementia.
- Cortical circuit issues: It helps pinpoint brain circuits that aren't working properly, explaining cognitive or behavioral symptoms.
- Tracking changes: TMS may also monitor disease progression or treatment effects over time.
Is TMS Safe for People with Dementia?
TMS is widely considered safe and well-tolerated, even in older adults or those with cognitive decline. The most common side effects are mild:
- Scalp tingling or discomfort
- Light headache
- Temporary twitching of facial muscles during treatment
Serious complications, such as seizures, are extremely rare and occur in less than 0.1% of cases when protocols are followed. However, there may be a slightly higher risk of mania in people with dementia, as the condition can include mania-like symptoms. Careful screening can help reduce this risk.
Because it doesn’t require surgery, anesthesia, or hospitalization, TMS is especially suited to individuals who may be frail or who are managing multiple medical conditions.
TMS Services in New Mexico
If a loved one is showing early signs of memory loss or cognitive changes, TMS may help slow the decline and improve overall well-being—for them and those around them. At TMS New Mexico, we offer
personalized treatment plans using
advanced TMS technology, including options specifically for dementia. Contact us to learn how we may be able to help.
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