NICE has been notified about this procedure and it is part of its work programme. The Interventional Procedures Advisory Committee (IPAC) will consider this procedure and NICE will issue an interventional procedures consultation document about its safety and efficacy for 4 weeks’ public consultation. IPAC will then review the consultation document in the light of comments received and produce a final interventional procedures document, which will be considered by NICE before guidance is issued to the NHS in England, Wales, Scotland and Northern Ireland.
Status In progress
Process IP
ID number 1768
Description Transcranial magnetic stimulation (TMS) is done with the patient awake and sitting in a comfortable chair. The operator places an electromagnetic coil over a specific region of the head. The coil delivers electromagnetic pulses through the skull that stimulate neurons (brain cells) by inducing small electrical currents within the brain. Different areas of the brain may be targeted, and a variety of stimulation protocols may be used. Treatment with TMS usually comprises daily sessions lasting about 30 minutes, for a few weeks. The aim is to reduce the symptoms of OCD. In repetitive TMS (rTMS), repetitive pulses of electromagnetic energy are delivered at various frequencies (low or high) or stimulus intensities. The intensity of stimulation is usually titrated against the minimum intensity needed to elicit a motor response when stimulating the motor cortex, known as the motor threshold. Determining the motor threshold for rTMS can be done visually (such as by observing targeted hand muscle movements) or by using electromyography. Conventional rTMS is repeated individual pulses at a pre-set interval (train of pulses), and theta-burst rTMS is repeated short bursts of pulses at a pre-set interval (train of bursts). Deep TMS stimulates deeper and broader brain regions compared with conventional rTMS.

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Key events during the development of the guidance:

Date Update
07 January 2020 - 04 February 2020 Interventional procedure consultation

For further information on how we develop guidance, please see our page about NICE interventional procedures guidance