Protocols

Types of TMS

TMS protocols differ in frequency, burst pattern, laterality, session duration, and therapeutic intent.

High-frequency TMS: Often delivered to the left DLPFC and generally considered excitatory.

Low-frequency TMS: Often delivered to the right DLPFC and generally considered inhibitory.

Theta burst stimulation (TBS): Uses bursts delivered in a theta-patterned rhythm. Intermittent theta burst stimulation is typically considered excitatory, while continuous theta burst stimulation is generally considered inhibitory.

Deep TMS: Uses specialized coils to stimulate broader and somewhat deeper prefrontal regions.

These distinctions matter clinically because different devices and FDA-cleared protocols vary in treatment duration, tolerability, and workflow.

Types of TMS

Broader field stimulation