Here are some of the common questions that have been asked along with the answers to each.
How is MeRT℠ therapy different from rTMS?
Unlike standard rTMS therapy, which delivers stimulation to one location at a fixed frequency for all patients, the MeRT℠ approach individualizes the treatment frequency and location based on each patient's Quantitative EEG and EKG.
This results in a customized approach to the MeRT℠ protocol.
What takes place during a typical MeRT℠ session?
MeRT℠ therapy delivers magnetic pulses to specifically targeted areas of the brain.
A typical appointment of MeRT℠ consists of 30 trains of electromagnetic stimulation delivered for 6 seconds each with 54 seconds of rest period in between trains to a specific location on the head. The session lasts approximately 45 minutes.
What benefits may result from MeRT℠ therapy?
Functional recovery is the primary objective of treatment. Results are individual in nature, depending on the initial presenting symptoms.
Common benefits of functional recovery include:
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Better sleep
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Increased sleep duration
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Reduction of stress symptoms
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Reduction of pain
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Increased concentration and focus
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Improvement in mood
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Increased attention span
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Increased sociability
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Increased motivation
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Improvement in clarity of thought
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Decreased cravings (e.g. drugs and alcohol)
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Increased emotional stability
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Increased ability to adapt to change
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Improved self-confidence and self-esteem
What are the side effects of MeRT℠ therapy?
From our current data using the MeRT℠ approach, side effects are few and generally mild. The most commonly reported side effect is a mild tension headache at the site of stimulation, which can last 1-2 hours and responds well to over-the-counter analgesics.
Other possible side effects are hyperactivity, increased agitation, or euphoria. With brain stimulation there is also a risk of seizures; however the risk is minimal with MeRT℠ therapy.
At Synapse, Hawaii's Brain Treatment Center, we also limit the intensity of stimulation to further reduce any possible risk of seizure activity.
How soon after I start MeRT℠ therapy should I expect to see a response?
Every individual's response to treatment is different. We require every new patient to the clinic to undergo an Assessment Period.
We have found that in our Assessment Period we are able to determine whether or not the person would be a candidate for MeRT℠ treatment.
How long will the effects of MeRT℠ therapy last?
Most of the results we see are lasting. However, please know that results can vary per individual.
In general, the longer the length of MeRT℠ therapy, the longer the changes remain, especially if receiving MeRT℠ therapy for greater than one month.
Why is my protocol different from other patients’?
Since each brain is unique, the MeRT℠ protocol will be different for each patient as it is based on the individual's own EEG/EKG data.
Absolute and relative contraindications for cortical MeRT℠ treatment
Absolute contraindications for cortical MeRT℠ treatment:
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)
Cochlear implant
Aneurysm clips, coils, pipelines flow diversion
Pregnant or breast feeding
Primary brain cancer / metastatic legions in brain (unless palliative care)
Magnetic dental implants
Implanted cardio-verter defibrillators (ICD)
Ocular implants
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
I am interested in treatment. How do I get started?
Please call Synapse at 808-754-1027 or submit an inquiry on our website www.synapsehawaii.com/contact/to our new patient coordinator. They will then contact you to schedule a time for you to meet Dr. Yim and discuss your hopes for treatment. After your initial visit, your baseline EEG appointment and EEG review appointment with Dr. Yim will be scheduled. After you receive Dr. Yim's approval for treatment during your baseline EEG review, you may then schedule treatment.
How is treatment scheduled?
Treatment is scheduled in two-week increments, five consecutive days per week (Monday through Friday), one session per day, at the same time every day with each treatment session lasting approximately 45 minutes. In addition to daily treatment, a follow-up EEG and EEG review with the doctor is scheduled near the end of each two-week treatment period to monitor your progress and response to treatment.
It is recommended that individuals undergo treatment for a minimum of six consecutive weeks in order to achieve maximum, long-lasting benefits of MeRT. If you have questions about scheduling treatment, please talk to your Synapse technician or call our office at 808-204-4989.
Do I need a diagnosis to start treatment?
No, you do not need a diagnosis to start MeRT treatment. However, we recommend that you receive a diagnosis prior to starting treatment, especially for those hoping to treat autism. Having a diagnosis will better help us at Synapse create an accurate treatment protocol and monitor your child's response to treatment.
Are diagnostic services for autism, ADHD, or any other neurological conditions available at Synapse?
No. We do not provide assessment or any diagnosing services of any neurological or mental health conditions at Synapse.
Should I be doing anything else besides MeRT to help myself or my child?
We highly recommend that you or your child work with other medical and/or mental health service providers (e.g., psychiatrist, psychologist, therapist, etc.) in addition to MeRT. MeRT treatment combined with other interventions (e.g., individual or family therapy, ABA therapy, parent coaching, medication, etc.) is the most effective path towards clinical improvement.
Do I need to stop taking my medications to start MeRT?
No. We recommend that you continue taking your prescribed medications while receiving MeRT, but please inform the doctor of all medications prior to starting treatment.
Will I need additional MeRT treatment in the future?
Additional MeRT in the future is completely optional. Typically, the benefits you gain after completing the recommended six weeks of MeRT is long-term. However, patients may choose to opt for additional treatment in the future if they wish to pursue additional benefits.
Do you take insurance?
Unfortunately, MeRT treatment is not covered by insurance, except in some cases for Drug-Resistant Depression and OCD. At Synapse, we do not file insurance on your behalf.