At Madrona Clinics, we leverage the innovative BrainsWay Deep TMS technology, which includes the H1, H4, and H7 coils, to provide personalized and effective treatment options. Often referred to as “deep TMS,” this advanced technology is FDA-cleared for a range of indications, including major depressive disorder (MDD), obsessive-compulsive disorder (OCD), and smoking cessation. In addition, we offer off-label treatments for other conditions, such as Anxiety, Post-Partum Depression (PPD), and PTSD, based on emerging-evidence and clinical expertise.

MIND-TMS

Madrona Clinics develops accelerated TMS protocols are tailored for individuals seeking rapid relief, condensing treatment into an efficient 4-6 day program. These protocols form a cornerstone of our MIND (Madrona Integrated Deep) TMS program. The MIND-TMS^sm program offers a comprehensive and holistic approach designed to promote enduring results and support your long-term well-being.

Book Appointment

Conventional rTMS | iTBS

Madrona Clinics offer’s conventional TMS protocols such as repetitive Transcranial Magnetic Stimulation (rTMS) as well as shorter Intermittent Theta-burst Stimulation (iTBS) protocols. These protocols are typically completed within 6-10 weeks, followed by maintenance treatments which vary in frequency based on your unique needs. These treatments are typically approved for coverage by insurance.

MIND-TMS Protocol

Madrona Clinics Accelerated TMS protocols deliver rapid-acting results within just 4-6 days, offering an expedited pathway to relief without compromising quality of care. While this service is not currently covered by insurance, it is tailored for individuals seeking immediate and effective solutions.

MIND-TMS is designed with convenience and efficacy in mind. Available over weekends to accommodate busy schedules and minimize disruption, it seamlessly integrates adjunctive treatments such as D-Cycloserine, Ketamine/Esketamine, psychotherapy, and movement-focused activities.

This holistic approach promotes behavioral activation and harnesses neuroplasticity induction, supporting long-term, durable results. By combining cutting-edge neuromodulation with evidence-based adjunctive therapies, the MIND-TMS promotes lasting improvements.

Q & A

Do you offer Stanford Intelligent Accelerated Neuromodulation Therapy (SAINT)?

Madrona Clinics is committed to staying at the forefront of discovery and innovation by fostering collaborations, participating in clinical trials, driving quality improvement initiatives, and prioritizing continuing education. Through these efforts, we aim to advance mental healthcare and deliver cutting-edge, evidence-based treatments options.

While emerging research on neuroimaging and personalized targeting holds great promise, our current approach prioritizes evidence-based practices that maximize therapeutic outcomes while respecting your time and resources. The H-coil aligns with this commitment, offering robust engagement of key neural networks and proven efficacy in treating conditions like major depressive disorder (MDD).

The H-coil’s ability to stimulate larger and deeper brain regions, including the dorsolateral prefrontal cortex (DLPFC) and subgenual anterior cingulate cortex (sgACC) pathway, allows it to address critical circuits implicated in depression treatment. Clinical studies have demonstrated high response and remission rates with H-coil protocols, achieving outcomes comparable to or exceeding those of experimental approaches, while also simplifying treatment delivery.

While we currently utilize the H-coil as our primary modality, Madrona is excited about the potential for future advancements in personalized targeting. Improved navigation techniques, particularly when integrated with next-generation technologies such as low-intensity focused ultrasound (LIFUS), hold the potential to further enhance treatment outcomes.

Spatial Considerations:

Electric Field (E-Field) Modeling

E-field modeling offers valuable insights into how TMS-induced electric fields interact with the brain. While these models represent an important step forward, the translation of E-field data into meaningful clinical outcomes is still in development.

Functional Connectivity

Functional connectivity, derived from neuroimaging techniques like fMRI, plays a key role in advanced targeting approaches such as SAINT (Stanford Accelerated Intelligent Neuromodulation Therapy). SAINT targets the DLPFC-sgACC pathway, leveraging connectivity data to optimize stimulation for people with MDD.

While promising, FC-based approaches currently explain only a small portion (~3%) of the variance in treatment outcomes, underscoring the need for further refinement. Additionally, the resource-intensive nature of neuroimaging-based navigation poses practical challenges for widespread clinical implementation. The H-coil provides a compelling alternative, achieving comparable engagement of the DLPFC-SGC pathway through broader stimulation, without requiring advanced imaging or navigation tools.

Temporal Considerations:

Temporal personalization approaches, such as phase-dependent plasticity and frequency-tuned TMS, represent exciting avenues for optimizing treatment by aligning stimulation with individual oscillatory patterns. However, these methods are still in an exploratory phase and have yet to be validated through large-scale clinical trials.

The technical requirements for real-time monitoring, such as EEG phase matching, also add complexity and cost, which may limit their current practicality. Nonetheless, these approaches remain an important area of research, and we look forward to advancements that may make them more accessible and clinically
impactful in the future.

Does TMS impact neuroplasticity?

We leverage the transformative power of neuroplasticity induction via TMS to foster recovery and resilience. By capitalizing on neuroplasticity induction, our multi-modal treatment plans are designed to create lasting improvements in mental health and overall well-being.

TMS works by stimulating neuroplastic processes across synaptic, neural, and circuit levels. It enhances the production of Brain-Derived Neurotrophic Factor (BDNF), fostering long-term potentiation and synaptic remodeling. These changes regulate key neurotransmitters like dopamine, serotonin, GABA, and
glutamate, which are crucial for mood regulation and cognitive function.

Which TMS devices are used?

At Madrona, we leverage the innovative BrainsWay Deep TMS technology, which includes the H1, H4, and H7 coils, to provide personalized and effective treatment options for you. Madrona’s focus on holistic, data-driven care means we integrate cutting-edge neuromodulation techniques with personalized treatment plans. By harnessing the multifaceted benefits of rTMS, we aim to empower you with evidence-based interventions that deliver meaningful, lasting improvements in mental health and quality-of-life.