Repetitive Transcranial Stimualtion (rTMS) therapy delivers a standardized treatment approach that uses the same protocol by stimulating the same location of the brain at a fixed frequency for all patients. MeRT delivers an individualized treatment approach that varies in treatment location, treatment frequency, and stimulation intensity based on each patient’s quantitative EEG and EKG data.

MeRT’s intensity of stimulation is lower than rTMS since less intense magnetic stimulation is needed to generate the same level of results due to MeRT’s use of individually tailored treatment location(s) and frequencies. Thus, less side effects are associated with MeRT compared to rTMS.

At Mālama Manaʻo, we require a diagnosis for individuals seeking treatment for Autism Spectrum Disorder prior to starting MeRT. For all other conditions, a diagnosis is not necessary to start MeRT. However, for those seeking insurance coverage for multi-medication resistant depression, a diagnosis is required. We also highly recommend all individuals receive diagnostic assessment and establish care with appropriate providers.

Absolute contraindications for cortical MeRT treatment at Mālama Manaʻo:

• Pacemaker
• Defibrillator
• Vagal Nerve Stimulator
• VP Shunt/ Magnetic intracranial shunts
• Deep Brain Stimulator
• Epidural Cortical stimulator
• Steel shunts/stents
• Cranial metal fragments (i.e. shrapnel, excluding titanium)
• Schizophrenia or history of psychosis (i.e. hallucinations, delusions)
• Cochlear implant
• Aneurysm clips, coils, pipelines flow diversion
• Pregnant or breastfeeding
• Primary brain cancer/metastatic lesions in brain (unless palliative care)
• Magnetic dental implants
• Implanted cardio-verter defibrillators (ICD)
• Ocular implants
• Untreated seizure activty
• *Bipolar Disorder Type I/II
• *Schizophrenia or Schizoaffective Disorder
• *Active Suicidal Ideation

*May be treated at other TMS/MeRT centers, but not at Mālama Manaʻo

Relative contraindications (requiring closer protocol attention, but not disqualifying someone from receiving cortical MeRT℠ treatment:):

• History of Seizure or seizure disorder
• Titanium shunts/stents
• Spinal Cord Stimulator
• Hearing aids
• Ferrous cortical implants
• Magnetic ink tattoo
• Bipolar Disorder Type I/II
• Baha Implant

We currently only provide qEEG, consultation, and treatment services related to MeRT at Mālama Manaʻo.  Diagnostic assessment and any other services are not available at this time. 

We can connect you with our parent company Manakai O Mālama Integrative Healthcare Group and Rehabilitation Center’s behavior health team who offers diagnostic assessment and therapy for adults. 

Common benefits of MeRT include reduction of symptoms and behaviors interfering with daily functioning  and the following:

• Better sleep
• More relaxed; less anxiety
• Mood improvement and increased emotional stability
• Increased ability to adapt to change
• Improved self-confidence, self-esteem, and sociability
• More “presence” with Autistic patients (interaction and awareness with the world around them)
• Better concentration and focus
• Improved memory
• Greater ability to cope with stress
• Increased motivation
• Decreased cravings for drugs and alcohol

Results are individual in nature, depending on the initial presenting symptoms, and are not guaranteed. 

Side effects are few,  generally mild,  and short-lived. The most commonly reported side effect is a mild tension headache, which typically responds well to over-the-counter painkillers. Other possible side effects are hyperactivity, fatigue, increased agitation, or euphoria. If side effects occur during treatment, inform your technician so that treatment may be adjusted accordingly.

With brain stimulation there is also a risk of seizures; however the risk is minimal (1: 100,000) with MeRT therapy. At Mālama Manaʻo, MeRT treatment protocols take into account past or present seizure activity to reduce the risk of seizure caused by treatment.

MeRT is painless and non-invasive. MeRT stimulation is accompanied by a clicking noise and often feels like light to firm tapping in the stimulation area. If any discomfort is reported by a patient, our technicians are trained to adjust treatment intensity accordingly.

Every individual’s response to treatment is different. We require every new patient to undergo a 2 week assessment period. Generally, most people experience some sort of benefit within the first 2-3 weeks of treatment.

We recommend that you continue taking your prescribed medications while receiving MeRT and do not add, stop, or change any medications while receiving MeRT to ensure accurate progress monitoring. Please inform our clinician of all medications you are taking prior to starting treatment and let your technician know if any changes in medication occur during treatment.

Patients may choose to opt for additional treatment in the future if they wish to “refresh” benefits or pursue additional benefits. We recommend that patients take a 3 month break before pursing additional MeRT. 

After your initial consultation and baseline assessment of a qEEG and qEEG review, treatment is scheduled in 10 treatment session intervals.

Treatment sessions are once per day, five days per week (Monday through Friday), at the same time every day over the course of two weeks. Each treatment session lasts approximately 30-45 minutes.

A follow-up qEEG and qEEG review with the clinician is scheduled near the end of each 10 treatment period to monitor your progress and inform continued care.

It is recommended that individuals complete at least four to six consecutive weeks of MeRT in order to achieve maximum, long-lasting benefits.

We highly recommend that you pursue other modalities of treatment for you or your loved one’s condition in addition to MeRT. Best practice for most health conditions is a multimodal approach as there are various components to treating different conditions (i.e. medical, psychological, educational, environmental, etc.).  Many past patients report that MeRT increased their rate and level of benefits in other forms of treatment such as counseling, Applied Behavior Analysis, neurofeedback, etc. which increased their total level of clinical gains(s). 

Our office is in the Gold Bond Building at 677 Ala Moana Blvd Honolulu, Hawaii 96813 within the Manakai O Malama office.

The Manakai O Mālama office is on the 9th floor Suite 950. We recommend patients to enter the parking garage from Coral St. and use the Ewa Wing elevators. 

You may park in the Gold Bond Building parking lot on Ala Moana Blvd at 677 Ala Moana Blvd. Honolulu, HI 96813. We recommend entering the parking garage from Coral St. and using the Ewa Wing elevators. Parking validation for a discounted rate ($1.75/hour) is available.