Description
Introduction
Navigating mental health treatment options can feel like learning a new language—particularly when exploring innovative approaches like Transcranial Magnetic Stimulation (TMS). This comprehensive glossary demystifies TMS therapy as offered at Neuralia TMS Melbourne, breaking down the essential concepts, procedures, and practical aspects in an accessible A-Z format.
Established in December 2023, Neuralia TMS Melbourne (operating as "Cortical TMS powered by Neuralia") provides non-invasive brain stimulation therapy for conditions including treatment-resistant depression, anxiety, PTSD, OCD, and chronic pain. This alphabetical guide covers everything from the scientific foundations to the everyday experience of TMS treatment at their Moonee Ponds clinic.
Whether you're considering TMS therapy, supporting someone who is, or simply curious about this treatment option, this glossary offers a unique pathway through the information landscape—allowing you to explore concepts in any order while building a comprehensive understanding of what TMS at Neuralia Melbourne entails.
A is for Accessibility
At Neuralia TMS Melbourne, accessibility encompasses both physical and financial dimensions of treatment. Located at 102/149-155 Pascoe Vale Rd in Moonee Ponds, the clinic is positioned to serve patients throughout the Melbourne metropolitan area, with nearby parking options and public transportation access.
Financial accessibility represents a cornerstone of Neuralia's approach. For patients with treatment-resistant depression who meet Medicare criteria, treatment costs are largely covered by Medicare following its November 2021 listing. This includes full Medicare rebates with $0 out-of-pocket expenses for:
- Initial Consultation: $85.00
- TMS Mapping Session: $173.50
- Standard TMS Session: $148.90
- Follow-up Review with TMS Doctor: $85.00
For patients requiring services not covered by Medicare, Neuralia maintains transparent pricing:
- Extended TMS Session: $180.00 (Medicare rebate $148.90; $31.10 out-of-pocket)
- Non-Medicare covered sessions: $180.00
- Cancellation Fee (less than 24 hours notice): $50.00
This transparent fee structure makes advanced mental health treatment more accessible to Melburnians from diverse financial circumstances.
B is for Brain Circuitry
TMS therapy at Neuralia Melbourne works directly with brain circuitry—the interconnected neural networks that govern mood, thoughts, and behaviors. Unlike medications that affect chemical signaling throughout the entire body, TMS targets specific brain circuits that function abnormally in various mental health conditions.
In depression, circuits involving the dorsolateral prefrontal cortex often show reduced activity. Anxiety disorders involve hyperactivity in fear-processing networks. OCD manifests as dysfunctional connectivity between regions governing impulse control and emotional responses. PTSD involves disrupted circuits between the amygdala and prefrontal regions.
Neuralia TMS Melbourne tailors treatment protocols to address these specific circuit abnormalities. By repeatedly stimulating targeted regions, TMS promotes neuroplasticity—the brain's ability to form new neural connections and reorganize existing ones—potentially restoring more normal circuit function over time.
Understanding this circuitry-based approach helps explain why TMS may succeed in cases where medication has failed: rather than broadly altering brain chemistry, it directly addresses the specific neural networks involved in each condition.
C is for Calibration
Calibration represents a crucial element of TMS therapy at Neuralia Melbourne, ensuring that treatment is precisely tailored to each individual's neurophysiology. Before beginning treatment, patients undergo a mapping procedure to identify the optimal stimulation location and determine their Resting Motor Threshold (RMT).
This process typically involves:
This personalized calibration ensures that each patient receives the optimal stimulation intensity—strong enough to effectively influence neural activity but not stronger than necessary for therapeutic benefit. The mapping session typically occurs after the initial consultation and before beginning the regular treatment course.
D is for Depression Treatment
Depression treatment represents the primary focus at Neuralia TMS Melbourne, particularly treatment-resistant depression that hasn't responded adequately to medication or psychotherapy. TMS was listed under Medicare in Australia specifically for Treatment Resistant Depression in November 2021, reflecting its established efficacy for this condition.
Treatment-resistant depression is typically defined as depression that hasn't shown adequate improvement after trials of at least two different antidepressant medications at sufficient doses and durations. For these patients, TMS offers a fundamentally different approach by directly stimulating brain regions that show decreased activity in depression.
The standard TMS protocol for depression at Neuralia Melbourne typically involves:
- Stimulation of the left dorsolateral prefrontal cortex
- 30-minute sessions
- 3-5 sessions per week
- 4-8 weeks total duration (typically 35 sessions for Medicare-covered treatment)
Research consistently shows that approximately 50-60% of patients with treatment-resistant depression respond positively to a standard course of TMS treatment, with many maintaining improvements for months or years afterward.
E is for Evidence Base
The evidence base supporting TMS therapy represents decades of research into its safety and efficacy. First developed in 1985, TMS has undergone extensive clinical investigation, leading to FDA approval for depression treatment in 2008 and Medicare listing in Australia in 2021.
Key elements of this evidence base include:
- Multiple randomized controlled trials demonstrating effectiveness for treatment-resistant depression
- Meta-analyses showing consistent treatment effects across studies
- Long-term follow-up studies documenting sustained benefits
- Growing evidence supporting applications for anxiety, PTSD, OCD, and chronic pain
- Extensive safety data from thousands of patients worldwide
At Neuralia TMS Melbourne, treatments follow evidence-based protocols refined through this research. Each treatment plan is grounded in established scientific literature while allowing for personalization based on individual needs and response patterns.
This solid evidence foundation distinguishes TMS from experimental or alternative treatments, positioning it as a mainstream, science-backed intervention for mental health conditions that haven't responded adequately to conventional approaches.
F is for Frequency
Frequency in TMS therapy refers to how rapidly the magnetic pulses are delivered, measured in Hertz (Hz) or pulses per second. Different pulse frequencies produce different effects on brain activity, allowing protocols to be tailored for specific conditions.
At Neuralia TMS Melbourne, treatment protocols utilize various frequencies based on the therapeutic goal:
- High-frequency stimulation (typically 10-20 Hz): Used to increase brain activity in underactive regions, commonly applied in depression treatment to the left dorsolateral prefrontal cortex
- Low-frequency stimulation (typically 1 Hz): Used to decrease hyperactivity in overactive brain regions, sometimes applied in anxiety or certain types of chronic pain
- Theta-burst stimulation: A specialized pattern that delivers bursts of pulses at specific intervals, potentially producing effects more rapidly than standard protocols
The TMS psychiatrist determines the appropriate frequency for each patient based on their specific condition, treatment goals, and individual characteristics. This frequency parameter represents one of several variables that can be customized to optimize treatment outcomes.
G is for Gradual Response
Gradual response characterizes the typical pattern of improvement with TMS therapy at Neuralia Melbourne. Unlike some treatments that produce immediate effects, TMS benefits typically develop progressively throughout the treatment course as repeated stimulation promotes neuroplastic changes in brain circuits.
This gradual response pattern often follows a timeline:
- Weeks 1-2: Minimal noticeable changes, though subtle improvements in sleep or energy may begin
- Weeks 3-4: More noticeable improvements often emerge, such as reduced anxiety, improved concentration, or lifting mood
- Weeks 5-6: Significant therapeutic effects frequently become apparent, with substantial symptom reduction and enhanced functioning
- Post-treatment: Benefits often continue developing even after completing the treatment course as the brain reinforces new neural pathways
Understanding this gradual nature helps set appropriate expectations. The progressive development of benefits reflects the underlying neurobiological mechanisms—creating lasting changes in brain circuit function requires consistent stimulation over time rather than producing immediate dramatic effects.
H is for Healthcare Team
The healthcare team at Neuralia TMS Melbourne includes specialized professionals dedicated to providing comprehensive TMS therapy:
TMS Psychiatrists:
- Conduct initial consultations and assessments
- Determine treatment suitability and appropriate protocols
- Perform mapping procedures to calibrate treatment parameters
- Monitor progress and adjust treatment plans as needed
- Provide follow-up reviews and recommendations
TMS Nurses/Technicians:
- Deliver daily TMS sessions
- Position the treatment coil precisely
- Monitor comfort and response during treatment
- Track progress between psychiatrist appointments
- Provide education and support throughout the treatment course
Administrative Team:
- Manages scheduling and appointments
- Assists with referral processing
- Helps navigate Medicare and insurance coverage
- Coordinates care with referring doctors
While comprehensive information about the full Melbourne team is limited in available data, Dr. Shanek Wick serves as the Director of Neuralia TMS, leading the clinical team with a focus on personalized, evidence-based care tailored to individual patient needs.
I is for Integration
Integration of TMS therapy with other treatment approaches represents a key philosophy at Neuralia TMS Melbourne. Rather than viewing TMS as a standalone intervention, the clinic emphasizes its role within a comprehensive mental health treatment framework.
This integrated approach involves:
- Maintaining communication with referring doctors
- Encouraging continuation of beneficial psychotherapy
- Carefully coordinating medication management during TMS
- Considering lifestyle factors that support brain health
- Developing post-TMS strategies to maintain improvements
For many patients, TMS provides a neurobiological foundation that enhances the effectiveness of other treatments. For example, patients often report that therapy concepts that previously seemed abstract become more applicable after TMS improves their baseline brain function. Similarly, some patients who previously showed limited medication response find that a lower medication dose becomes effective after TMS treatment.
This integration philosophy recognizes that mental health conditions typically benefit from multi-modal approaches addressing biological, psychological, and social dimensions simultaneously.
J is for Journey Timeline
The journey timeline for TMS therapy at Neuralia Melbourne follows a structured progression from initial consideration through treatment completion and follow-up:
Pre-Treatment Phase:
- Discussing TMS as an option with your regular healthcare provider
- Obtaining a referral to Neuralia TMS Melbourne
- Initial consultation with TMS psychiatrist (45-60 minutes)
- Mapping session to calibrate treatment parameters (approx. 60 minutes)
Active Treatment Phase:
- Standard course: 3-5 sessions weekly for 4-8 weeks
- Typical session duration: 30 minutes
- Regular monitoring of response and side effects
- Possible adjustments to treatment parameters based on response
Post-Treatment Phase:
- Follow-up review with TMS psychiatrist
- Assessment of response and future recommendations
- Detailed treatment summary provided to referring doctor
- Possible maintenance sessions if beneficial
This timeline provides structure and predictability for patients undertaking TMS therapy, though individual experiences may vary based on specific conditions, response patterns, and treatment protocols.
K is for Knowledge Base
The knowledge base underlying TMS therapy represents over 35 years of scientific research and clinical experience since its development in 1985. This accumulated knowledge guides treatment approaches at Neuralia TMS Melbourne:
Historical Development:
- 1985: First demonstration of non-invasive brain stimulation using magnetic fields
- Early 1990s: Initial applications for depression and neurological conditions
- 2008: FDA approval for depression treatment
- 2021: Medicare listing in Australia for Treatment Resistant Depression
Core Scientific Principles:
- Electromagnetic induction: Magnetic fields pass through the skull to generate small electrical currents in brain tissue
- Neuronal activation: These currents depolarize neurons, influencing their firing patterns
- Neuroplasticity: Repeated stimulation promotes lasting changes in neural connectivity
- Circuit modulation: Different stimulation parameters can either increase or decrease activity in targeted brain circuits
Ongoing Research:
- Refinement of targeting techniques
- Development of accelerated protocols
- Expansion to additional conditions
- Personalization of treatment parameters
This robust knowledge foundation distinguishes TMS from experimental or alternative approaches, positioning it as a mainstream, evidence-based intervention with established mechanisms of action and documented efficacy.
L is for Location Specifics
Neuralia TMS Melbourne operates from a specific location designed to provide accessible, professional TMS therapy services:
Clinic Address: 102/149-155 Pascoe Vale Rd Moonee Ponds VIC 3039 Australia
This Moonee Ponds location offers several advantages:
- Central position serving patients throughout Melbourne metropolitan area
- Professional medical setting providing privacy and appropriate clinical facilities
- Accessible via major roadways
- Proximity to public transportation options
- Available parking nearby
Contact Information:
- Phone: 03 9122 5246
- Email: [email protected]
- Website: https://www.neuraliatms.com.au/locations/melbourne/
The clinic operates as "Cortical TMS powered by Neuralia," representing an expansion of the Neuralia TMS network from its established presence in Western Australia. Australian Business Number (ABN) records show the business became active on December 12, 2023, making it a relatively recent addition to Melbourne's mental health treatment landscape.
M is for Mechanism of Action
The mechanism of action for TMS therapy involves direct stimulation of neural activity through electromagnetic principles. At Neuralia TMS Melbourne, patients receive treatment based on these established biological mechanisms:
Unlike medications that alter chemical signaling throughout the entire body, TMS works directly on specific brain regions, explaining its favorable side effect profile. This localized approach targets the neural circuits involved in particular conditions while minimizing effects on unrelated brain regions or body systems.
N is for Non-Invasive Approach
The non-invasive approach of TMS therapy represents one of its most significant advantages compared to other brain stimulation treatments. At Neuralia TMS Melbourne, this non-invasive nature translates to several practical benefits:
No Surgical Procedures:
- No incisions or implants required
- No anesthesia needed
- No recovery time from surgical intervention
- No infection risk associated with implanted devices
No Systemic Effects:
- Treatment focused specifically on targeted brain regions
- Minimal impact on unrelated body systems
- No significant drug interactions
- No need to adjust for metabolism or elimination
Outpatient Convenience:
- 30-minute treatments without hospital admission
- Drive yourself to and from appointments
- Resume normal activities immediately
- Maintain work, study, and family commitments
Reversibility:
- No permanent physical changes to brain structure
- Treatment can be discontinued without surgical removal
- Parameters can be adjusted easily throughout treatment
This non-invasive approach makes TMS particularly suitable for patients who prefer alternatives to surgery or medications, need to maintain daily responsibilities throughout treatment, or have experienced intolerable side effects from systemic treatments.
O is for Obsessive-Compulsive Disorder Treatment
Obsessive-Compulsive Disorder (OCD) treatment represents one of several specialized applications of TMS therapy at Neuralia Melbourne. For patients with OCD that hasn't responded adequately to standard treatments like SSRIs and Exposure and Response Prevention therapy, TMS offers a different approach targeting the specific brain circuits involved in obsessive thoughts and compulsive behaviors.
TMS protocols for OCD typically focus on regions including:
- The supplementary motor area (involved in planning and executing repeated movements)
- Connections between the orbitofrontal cortex and striatum (circuits involved in habit formation and compulsive behaviors)
- Areas regulating anxiety responses that drive OCD symptoms
While Medicare currently covers TMS specifically for treatment-resistant depression, Neuralia TMS Melbourne offers OCD protocols for patients seeking alternatives to standard treatments. The TMS psychiatrist can determine whether this approach might be suitable based on individual symptoms, previous treatment responses, and clinical presentation.
Research suggests that approximately 35-40% of patients with treatment-resistant OCD show clinically meaningful improvement with appropriate TMS protocols, with benefits often developing gradually throughout the treatment course.
P is for Personalization
Personalization stands as a core principle at Neuralia TMS Melbourne, recognizing that optimal TMS therapy requires tailoring to each individual's unique characteristics and needs. This personalized approach encompasses multiple dimensions:
Treatment Parameters:
- Stimulation location based on individual brain anatomy
- Intensity calibrated to personal motor threshold
- Protocol selection based on specific condition and symptoms
- Session frequency adapted to response patterns and practical needs
Scheduling Flexibility:
- Options for morning, midday, or afternoon appointments
- Possibility of concentrated or extended treatment courses based on individual circumstances
- Accommodation of work, study, or family commitments
Response Monitoring:
- Regular assessment of symptom changes
- Tracking of side effects and tolerance
- Adjustment of parameters based on emerging response patterns
- Individualized decisions about maintenance treatment
Integration with Existing Care:
- Coordination with ongoing psychotherapy
- Collaboration with medication management
- Communication with referring healthcare providers
- Personalized post-treatment recommendations
This personalized approach recognizes that mental health conditions manifest uniquely in each individual and that treatment effectiveness depends on adapting evidence-based protocols to specific patient characteristics and circumstances.
Q is for Questions and Consultations
Questions and consultations form the starting point of the TMS journey at Neuralia Melbourne. The initial consultation provides an opportunity to address questions about the treatment process, expected outcomes, and practical considerations.
Common Questions Addressed During Consultations:
- How does TMS work for my specific condition?
- What does the treatment feel like?
- What side effects might I experience?
- How many sessions will I need?
- How soon might I notice improvement?
- Can I continue my current medications?
- Will Medicare cover my treatment?
- What happens if TMS doesn't help?
- How long do benefits typically last?
- Will I need maintenance treatment?
The consultation process typically involves:
This consultation requires a referral from a GP or psychiatrist and is typically covered by Medicare for eligible patients. The discussion provides the foundation for informed decision-making about whether TMS represents an appropriate treatment option for your specific situation.
R is for Referral Process
The referral process forms the gateway to TMS treatment at Neuralia Melbourne. All patients require a referral from a GP or psychiatrist before beginning treatment, establishing a collaborative approach between the referring doctor and the TMS team.
Key Elements of an Effective Referral:
- Summary of your clinical condition and diagnosis
- Outline of treatments attempted to date
- For depression: Documentation of at least two antidepressant trials with inadequate response (required for Medicare coverage)
- Specific request for TMS therapy assessment
- Relevant medical history that might affect treatment suitability
The Referral Pathway:
This structured referral process ensures appropriate patient selection, documentation for Medicare requirements, and continuity of care between your existing healthcare providers and the specialized TMS team.
S is for Side Effects Profile
The side effects profile of TMS therapy represents one of its significant advantages compared to many conventional treatments. At Neuralia TMS Melbourne, patients typically experience minimal side effects, most of which are temporary and mild.
Common Side Effects:
- Scalp discomfort during treatment (typically mild to moderate)
- Headache after sessions (usually responds well to over-the-counter pain relievers)
- Facial muscle twitching during active stimulation (normal and not harmful)
- Temporary hearing changes during treatment (mitigated by earplugs)
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