How does rTMS work?
From the magnetic coil to the nerve cell

rTMS rests on a basic law of physics (electromagnetic induction): a rapidly changing magnetic field generates an electrical current in a conductor. Here, the “conductor” is your brain tissue. For fractions of a second the coil produces a strong magnetic field that passes unhindered through skin and skull, unlike an electric current, which would be blocked by the scalp.

Directly beneath the coil, this field induces a small current flow that depolarises nerve cells (neurons) at that spot, making them fire. This does not stimulate the whole brain, but targets a region near the surface.

The coil’s shape is decisive for precision. We use a figure-8 coil on the MagVenture X100. In this design the magnetic fields of two round coils overlap exactly at the centre, where the induced field is strongest. This focuses the stimulus onto a relatively confined region rather than spreading it broadly.

The coil sits on an articulated support arm and is positioned precisely over the target area, for depression usually over the left dorsolateral prefrontal cortex. Which region is right for you is something we decide only after measuring, not by a fixed template.

A single pulse only briefly makes a nerve cell fire. The real effect comes from repetition: “repetitive” is in the name. Depending on frequency, rTMS can raise the excitability of a region (higher frequencies) or dampen it (lower frequencies).

Across many pulse trains and several sessions, the way a region works and connects with others can change more durably, this “relearning” is called neuroplasticity. That is why classic rTMS runs over several weeks. Modern accelerated protocols (theta-burst) compress many sessions into a few days.

You sit comfortably in a treatment chair; the coil rests against the outside of your head. A classic session lasts roughly 20–40 minutes depending on protocol, while theta-burst protocols take only a few minutes. You hear a rhythmic tapping and feel a tapping or tingling on the scalp, sometimes a slight twitch of the facial or forehead muscles.

The most common side effect is temporary headache or scalp tenderness. Seizures are very rare, which is why we carefully check contraindications (e.g. metal implants in the head) beforehand. Afterwards you can immediately resume your day; no recovery time is needed.

rTMS is best evidenced for depression, especially when medication has not helped enough. Further indications with growing to solid evidence include obsessive-compulsive disorder, anxiety disorders, chronic pain syndromes and motor rehabilitation after stroke.

rTMS is among the best-studied neuromodulation methods; not everyone responds the same way, studies describe averages, your course is individual. We summarise the evidence transparently on our Science & Studies page; how the method fits our overall concept is shown in Our Program. For more detail on the procedure and indications, see the rTMS treatment page.