Quick facts
- What it is
- TMS with 3D cameras and software that track the coil and your head in real time.
- Why it matters
- Helps place and repeat each pulse where it is meant to go.
- Our system
- StimGuide 3D navigation; no MRI needed.
- Evidence
- Research has not shown a large outcome difference versus standard placement.
- Insurance
- Covered as TMS when plan criteria are met; some insurers exclude navigated TMS, so we check first.
- Locations
- Wesley Chapel and Tampa, Florida.
Overview
TMS means transcranial magnetic stimulation: a magnetic field passes through the skull and activates certain brain areas. To improve results and tolerability, two things can be worked on: the characteristics of the pulse (intensity, frequency, depth) and the target location (accuracy and consistency).
Navigated TMS focuses on the second: better targeting.
Read the transcript
What is navigated TMS, and how does it differ from standard TMS? With standard TMS, the coil is positioned at the target area visually by the operator at that time.
With navigated TMS, we use 3D spatial cameras to track the position of the coil relative to the patient's head at all times. That means that every single pulse is delivered exactly where it was intended to be. This increases the patient's chances of having successful TMS treatment and, therefore, recovery from depression.
Navigated TMS compared with standard rTMS
Standard TMS places the coil using measurements on the head. Navigated TMS adds cameras and software that track your head and the coil in real time, so the technician is alerted if the coil moves off target.
Research has not shown a large difference in outcomes between navigated and standard placement. In practice, patients shift during a session, and tracking helps us notice and correct that quickly, which is why we use it.
How does navigated TMS work?
A navigated system uses 3D spatial cameras to track the treatment coil in real time in relation to your head. Paired with a frameless stereotactic navigation system, magnetic pulses can be delivered at highly accurate locations in the brain.
The system needs your head position (a lightweight tracker), the coil position, anatomical landmarks of your skull, and either a standardized brain model or your own MRI.
Advantages of navigated TMS
- An accurate, individualized dose of TMS
- Consistent targeting from session to session
- Treatment personalized to your head and brain anatomy
- Enhanced safety and comfort
Types of navigated TMS
Non-MRI navigated TMS calculates the target from skull landmarks, so no MRI is needed. It is more convenient and less costly, and is less precise than MRI-based methods. We use StimGuide 3D navigation.
Structural-MRI navigated TMS guides the operator to an anatomical target on your own MRI. It is more accurate, but an MRI is usually not covered by insurance for depression.
Functional-MRI navigated TMS individualizes the target to your brain's functional connectivity. It has been used in accelerated TMS research, but it is complex to perform and to reproduce, and lying still in an MRI is hard for some patients.
Navigated TMS in other settings
Navigated TMS is also used by neurosurgeons for noninvasive brain mapping before surgery. Direct cortical stimulation during surgery remains the gold standard.
Next steps
A psychiatric evaluation confirms whether TMS is right for you. Call (813) 867-2378 to get started.
Frequently asked questions
Sources and further reading
- Trapp NT, et al. Consensus review and considerations on TMS to treat depression. Clin Neurophysiol. 2025;170:206–233. Clinical TMS Society / NNDC / IFCN
- Perera T, et al. The Clinical TMS Society consensus review and treatment recommendations for TMS therapy for major depressive disorder. Brain Stimul. 2016;9(3):336–346. Clinical TMS Society
Medical information on this page is educational and not a substitute for professional advice. Individual results vary.