The History of PrTMS
By Kevin Murphy, M.D., Founder of MindSet
PrTMS is a personalized method of using repetitive transcranial magnetic stimulation (“rTMS”) that I developed for my medical practice. In my first 15 years as a doctor, I worked exclusively as a radiation oncologist treating brain cancers in adults and children. About five years ago, I started looking for a way to help my patients who were suffering from “Chemo Brain” – the thinking and memory problems that can occur during and after cancer treatment – and came across rTMS, a non-invasive form of brain stimulation therapy. As I learned more about rTMS, I drew on my experience in treating the brain to develop a personalized, patient-specific approach to providing the therapy. At the same time I was treating patients with Chemo Brain using my personalized approach for rTMS – now called PrTMS – I also used the approach to help a loved one with autism. As word got out about the success I was having in my practice, I began getting requests from patients to receive PrTMS therapy to treat other conditions where standard therapies had failed. I saw patients who suffered from Chemo Brain, autism, anxiety, depression, traumatic brain injury and concussions, post-traumatic stress disorder, cerebral palsy, addiction, and many other conditions. All of these conditions have one thing in common – they all involve the brain. I see PrTMS as a brain treatment that helps correct electrical signals in the brain. Unfortunately, but not surprisingly, many patients have more than one brain-related condition. An autistic patient may suffer from anxiety and depression. A veteran with PTSD may have also experienced multiple TBIs. The way to treat these conditions, in my opinion, is not to see each clinical disorder as something unique requiring different treatment(s), but as symptoms of problems with disorders in bioelectrical signals that impede communication between different areas of the brain. As we treat patients, a MindSet physician monitors them using several standard assessment tools for psychiatric and neurological conditions, which we use with quantitative EEG readings that measure electrical activity in different parts of the brain, and my other clinical observations. Typically, we will re-evaluate treatment plans each week based on patient response to the treatment being used. Also, like any doctor with any treatment, each experience taught me, and refined my thinking about how to provide what I considered the best possible care to my patients, until PrTMS became what it is today. To date, I have treated over 3,000 patients. I have observed that the PrTMS approach may help improve quality of sleep, lower stress, and improve mood and quality of life for patients with various underlying conditions. Most patients I have treated have experienced a benefit from PrTMS, but like any treatment, there is no guarantee of success, and PrTMS has not been studied in clinical trials.
Frequently Asked Questions
1. HOW DOES PRTMS WORK?
When a patient comes to MindSet, after reviewing the method and consent forms, and providing consent, we will conduct an initial clinical assessment, and collect quantitative EEG readings, which tell us about neuron firing frequencies at 19 locations in the brain. A MindSet physician will then develop a treatment plan using my proprietary algorithm which provides treatment frequencies, locations, and other parameter that we will use to treat our patients. Typically, 5 treatments per week are recommended, though in some cases, more or less might be used. Our goal is to identify a natural resonance frequency of a patient’s alpha wave, which reflects firing frequency of different neurons. The concept is to line up frequencies and amplitude in different parts of the brain. Each week, MindSet will run another qEEG and battery of tests, and determine whether adjustments are recommended. A common course of treatment is 5 days per week for 6-8 weeks, but as the “p” in PrTMS says, it’s a personal approach, so treatment frequency and length will vary.
2. HOW MANY PATIENTS HAVE YOU TREATED?
To date, Dr. Murphy has treated over 3,000 patients. Dr. Murphy also have consulted with other physicians who believed PrTMS could help their patients.
3. WHAT CONDITIONS DO YOU TREAT?
As we like to say at MindSet, we treat the brain. Based on Dr. Murphy’s understanding of the brain, informed by 20-plus years of experience as a physician, at MindSet we believe that through the personalized approach offered by PrTMS, the overall functional communication between different parts of the brain can be improved, which manifests itself in improved clinical scores. In our practice, we have treated patients with anxiety, depression, autism, traumatic brain injury and concussion, post-traumatic stress disorder, cerebral palsy, addiction, and many other neurological and psychiatric conditions.
4. HAS PRTMS BEEN STUDIED IN RESEARCH?
PrTMS has not been studied in clinical research studies to date, though there are trials in process (meaning protocols are under review, and studies are being set up to commence), which we hope will initiate soon. What rely on currently at MindSet is our own understanding of PrTMS and patient responses informed by several years of experience using personalized rTMS to help patients.
5. IS MINDSET ASSOCIATED WITH UCSD?
No, MindSet is a medical practice where we practice the PrTMS technique Dr. Murphy invented. Dr. Murphy also is a former UCSD Professor, and still works through UCSD as a radiation oncologist, but that work is not related to MindSet.
6. IS MINDSET ASSOCIATED WITH PEAKLOGIC?
Dr. Murphy, the owner of MindSet, is also CEO of and a shareholder in PeakLogic. PeakLogic subcontracts MindSet to provide doctor-to-doctor medical consulting services to other physicians who would like to use PrTMS. PeakLogic is also developing stand-alone software based on the proprietary treatment algorithm Dr. Murphy developed in medical practice. This stand-alone software is currently not available for use in clinical practice.
7. I HAVE HEARD ABOUT TREATMENTS AT OTHER CLINICS THAT SOUND LIKE PRTMS. WHAT’S THE DIFFERENCE?
Many physicians and non-physicians have been looking at ways of personalizing rTMS. We can’t speak about other practices, or comment on the basis of their approaches. All wecan say is that at MindSet we use PrTMS, a proprietary approach to treatment that was developed by Dr. Murphy. There also are rTMS devices that are FDA-cleared for treating major depressive disorder that is unresponsive to medication, obsessive compulsive disorder, and migraine. The instructions for use with those products do not employ a personalized PrTMS approach, and the PrTMS approach is not FDA-approved. Our experience at MindSet treating patients has led us to believe that personalization can help a patient and also allow the use of substantially lower bursts of energy (about 20% of that used with traditional rTMS), which may reduce the occurrence of side effects.
8. WILL PRTMS HELP ME?
We can’t guarantee success, and unfortunately some patients will not see a benefit. Usually, we make a determination within two weeks of starting treatment whether a benefit is being realized. If not, we’ll recommend discontinuing PrTMS.
9. IS PRTMS SAFE?
In our experience, patients have generally not experienced safety issues resulting from use of PrTMS. Also, the PrTMS approach uses about 20% of the power used with conventional rTMS which is intended to reduce adverse events resulting from higher power signals. However, the safety of PrTMS has not been assessed in clinical trials.
10. IS PRTMS COVERED BY MY MEDICAL INSURANCE?
You would need to check with your insurer, but we are happy to provide more information you can provide to your insurer, or help you check.
11. DOES MINDSET USE SOFTWARE?
We do use software in my practice to help make patient evaluations more efficient, but review all results based on our understanding of the PrTMS approach and issue final reports.
12. IS PRTMS FDA-APPROVED?
PrTMS is a method of developing and using personalized treatments plans for rTMS therapy. It is not a product, and is not FDA-approved. A company called PeakLogic, of which Dr. Murphy is CEO, is developing automated software that it ultimately hopes to evaluate in clinical trials to support FDA clearance.