Transcranial Magnetic Stimulation (TMS) has been approved by the Food and Drug Administration (FDA) for the treatment of depression, obsessive-compulsive-disorder (OCD), and smoking addiction and is showing promising results in reducing other substance use disorders (SUDs) including methamphetamine, heroin, cocaine, nicotine, and alcohol.

Studies shows that approximately 7 million people in the U.S. suffer from Alzheimer’s Disease (Alzheimer’s) with projections estimating that 13.8 million Americans will be diagnosed with the disease by 2060. Although there is no specific identified cause for Alzheimer’s, researchers are investigating genetics and other life style habits as possible issues that can have a direct or indirect impact on developing this life threatening neurologic disorder.

Researchers point to specific changes in the brain that occur at the onset and throughout the course of the disease while living with Alzheimer's. A variety of studies have shown that Alzheimer's patients have abnormal deposits of amyloid plaques, misfolded proteins that form spaces between nerve cells within the brain. These deposits inhibit neurons from maintaining existing connections and prevent the formation of any new neurological connections.

Current treatments for Alzheimer’s focuses on prescription medications that control the production of chemicals in the brain impacting memory and learning. Other medications target removing the amyloid proteins from the brain. These medications have shown the ability to slow the progression of the disease, but none have proven to reverse or halt its progression. Also, these medications may induce side effects such as headaches, digestive disorders, fever, chills, insomnia, loss of appetite, and anxiety.

Since the early 2000’s, researchers have begun looking at TMS as a clinical alternative in the battle against Alzheimer’s. According to Dr. Giacomo Koch, MD, PhD, a neurologist and neuroscientist at the Santa Lucia Foundation non-invasive brain stimulation laboratory in Rome, and a professor of human physiology at the University of Ferrara, Dr. Koch points out that TMS has been a safe and effective treatment for other aliments associated with brain functions and holds promise for assisting patients with Alzheimer’s.

Dr. Giacomo Koch and Dr. Emiliano Santarnecchi

Images courtesy of Sinaptica Therapeutics

Also, unlike prescription medications, TMS presents less impactful side effects with mild headaches being the most common side effect after treatments.

Along with co-founder, Emiliano Santarnecchi, PhD, PhD, Dr. Koch created Sinaptica Therapeutics, Inc., a company based in Cambridge, Massachusetts, for the purpose of exploring the use of TMS therapy in the battle against Alzheimer’s.

According to the Sinaptica Therapeutics, Inc. website, the company received the FDA breakthrough device designation for its Sinaptisim-AD. “The device combines neurostimulation, brain wave monitoring, and artificial intelligence (AI) to address the cognitive and functional decline in patients with neurological disorders.”

According to Dr. Koch, the key to the treatment is locating the region of the brain that is associated with memory functions. As previously stated, this region has become unable to transmit messages because the neuron network has become comprised due to the buildup of amyloid plaque.

Once the location of this region in the brain complex is identified, a paddle is externally applied to the patient’s head. The paddle attached to the TMS instrument provides the neurological magnetic impulses to the region while monitors provide real-time feedback about activity in the brain.

During an interview with NBC News, Koch stated, “The goal is to restore connections between the neurons by enhancing activity in certain areas relevant to the disease. This therapy is like training for the neurons.” Koch likens the treatment to strengthening muscles through exercise. Dr. Koch hopes that the electrical signals generated during the TMS therapy session enhance the ability of the neurons to make connections with one another and improve the functioning of the neurological network.

Dr. Koch and Dr. Santarnecchi are not the only researchers who use TMS to pursue a possible intervention for Alzheimer’s. Letizia Leocani, MD, PhD, and her team, Randy Buckner, PhD and his team, Young Hee Jung, MD, PhD, and her team and others have conducted recognized studies involving TMS and Alzheimer's patients. All of the studies show promising results, but due to their short duration and their limited sample population, they cannot confirm TMS’s ability to control Alzheimer’s on a long term basis.

Dr. Koch and Dr. Santarnecchi have completed Phase 2 of their study. The study involved 2 studies using two placebo-control groups. One study involved a test and placebo group lasting for a 6 month period and a second study utilizing the same format that ran for 12 months. Both studies showed similar results, the cognitive declined in patients receiving the TMS was slowed compared to the placebo group and patients receiving the TMS experienced a “stabilization of activities of daily living.”

Irina Skylar-Scott, MD, Memory Disorder Specialist for Stanford Medicine, was not part of the study, but is excited by the Dr. Koch’s and Dr. Santarnecchi’s findings. In her comments to NBC News, she points to the importance of completing a phase 3 trial across multiple centers “to see if this bears fruit.”

Lawrence Honig, MD, PhD, Neurologist for Aging and Dementia at Columbia University, Irving Medical Center, stated in an interview with NBC News, “If it works it will be very exciting. The findings are very, very preliminary. On the face of it, if you look at the numbers, it did better on a number of scales compared to the sham treatment — that’s good. But as in any study, the devil is in the details.”

Due to the limited results of the studies performed to date, TMS is not approved by the FDA for use as a therapy for the treatment of Alzheimer's. But, researchers, patients and others are hoping that further study will yield a better understanding of Alzheimer's and a possible cure.

Although TMS has not been approved for the treatment of Alzheimer's Disease, the FDA has granted “Off-Label” status to the treatment. “Off-label” means the use of the medication for the prescribed condition, dosage, or patient population has not been approved by the FDA. But, it is a common and legal practice when a doctor believes that it is in the patient’s best interest, even though it might not be fully tested for that specific use.

In European and Asian countries, similar studies in the use of TMS in the treatment of Alzheimer’s have been conducted. Not so surprisingly, the results of the studies of are similar to those conducted in the U.S. Researchers have found “repetitive TMS (rTMS) is capable of modulating cortical excitability and inducing long-lasting neuroplastic changes.”

As a result of the European studies, the European Commission (CE) granted certification for TMS to be traded (used0 on the extended Single Market in the European Economic Area (EEC) for the treatment of Alzheimer's and other mental disorders. The approval indicates the EEA certifies the EEA have been assessed to meet high safety, health, and environmental protection requirements.

Complicating the treatment of Alzheimer’s is the fact that Alzheimer's patients often find themselves suffering with some degree of depression. Unfortunately, the medications used to treat their Alzheimer’s do not control their depression. So, they often take additional prescription medications, with their own set of side effects, to reduce the complications of depression.

However, researchers throughout the world have found that rTMS can effectively treat both of these life altering aliments with minimum side effects, and none severe enough to impact daily activities.

Neuro Fitness is a mental health treatment center in the City of Gardena, co-founders, Paul Dillenback and Roman Cooper, state they have seen amazing improvements in their patients suffering from Alzheimer’s and/or depression as they progress through their treatments at Neuro Fitness. Dillenback states, “Not only do we see improvements in mental health issues, but we also see a positive change in their mental outlook and their interactions with staff.”

Dillenback states the key behind Neuro Fitness treatments is, “We focus on the patient’s personal treatment plan encompassing their physical, emotional and psychological health. Treatments at Neuro Fitness are geared to treat every aspect of the patient’s overall health.”

Before any patients undergoes any treatment an in-depth health assessment is conducted to determine the patient’s health care needs and if rTMS would be an effective treatment protocol. Once their health status and needs are identified treatment protocols are developed and shared with the patient, or in some cases the patient’s caregiver. The treatment plan includes treating the patient’s primary condition and, if necessary, any secondary mental health needs. Because these treatments may be covered by the patient’s medical insurance, if agreed to by the patient, the staff will contact the insurance provider to determine the degree of coverage the insurance company will provide.

In addition to treating Alzheimer's and depression, Neuro Fitness offers treatments for a variety mental health disorders including addictions, obsessive-compulsive disorder (OCD), and smoking cessation to mention a few.

Neuro Fitness is licensed with the California State Medical Board.

Neuro Fitness is located at 18726 S. Western Ave., Ste. 409, Gardena CA 90248.

For more information about Neuro Fitness contact:

Telephone (888) 828.5997; or

Visit their website: https://neurofitnessbh.com

Researchers are finding TMS and rTMS can be utilized to treat a growing number of mental health issues. The listing below includes mental health issues that positively respond to TMS or rTMS treatment protocols.

The following treatments have received approval from FDA and CE for use with patients.

Major Depressive Disorder Anxious Depression Smoking Addiction

Obsessive-Compulsive Disorder

Approval has been granted by the CE for the treatment of the following mental health issues. Also, TMS and rTMS has been cleared by the FDA for use in the U.S. utilizing “Advise and Patient Consent*.”

*Refers to the process where the healthcare provider informs the patient about their condition, treatment options, and potential risks and benefits, allowing the patient to make an informed decision about their care.

Bipolar Disorder Schizophrenia Alzheimer’s Disease Autism

Parkinson’s Disease Chronic Pain Multiple Sclerosis

Post Traumatic Stress Disorder (PTSD) Post Stroke Rehabilitation

If you want to learn more about Dementia and Alzheimer's Disease, here are some resources you may wish to begin with:

Alzheimer's Association

Alzheimer's Foundation of America

America Brain Foundation

BrightFocus Foundation

Dementia Society of America

Family Care Alliance

National Institute on Aging

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Steve Tabor

This South Bay native’s photographic journey began after receiving his first 35 mm film camera upon earning his Bachelor of Arts degree. As a classroom teacher he used photography to share the world and his experiences with his students. Steve began his photography career photographing coastal landscapes and marine life. His experiences have led him to include portraits and group photography, special event photography as well as live performance and athletics in his portfolio. As a contributor and photojournalist, he has published stories about the people, places and events in and around the Palos Verdes Peninsula and beyond.

Interested in seeing more of Steve’s work, visit website at: www.stevetaborimages.com