TMS is still under investigation. It is being studied for all sorts of
disorders, from learning disability to depression. It definitely
produces an effect on
brain function, but this is temporary and likely produces no permanent
effects or injury. However, treatments for depression sounds like
fertile ground for
expectation bias and pseudoscience. It is apparently difficult to get a
sham TMS because it produces neck pain, muscle twitching and other symptoms
that are difficult to produce. It has a similar effect size to ECT
(approx .5) . However, as I discussed a while ago, I think the effects
are a result of expectation bias. When faced with treatment that a
patient believes is ineffective or aversive, the patient gets out of the
therapy by endorsing positive change on the self-report dependent
measures. They don't tell the investigator, "This medication is making
me constipated and I don't want to take it any more." They say, "I
think I'm feeling a lot better (effect size approx .5). I don't think I
need the medication (psychotherapy, ECT etc.) any longer". If patients
are in an outpatient setting, they just leave therapy or the research
study and don't say anything.
Mike Williams
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