- About our treatments
- Contact us and referrals
- Physio - the team
- Frequently asked questions (FAQs)
- Accessibility Information
- Useful resources
TypeCentre for Neuromodulation
Our services at the centre are all geared to helping service users where traditional forms of treatment with mental health problems, such as depression, have failed.
At the centre we offer:
- Repetitive Transcranial Magnetic Stimulation (rTMS) using magnetic stimulation to target the part of the brain that regulates mood. We also provide rTMS treatments for other mental health conditions such as anxiey, obsessive compulsive disorder, post traumatic stress disorder, as well as cocaine addiction.
- Theta burst treatment (TBS) is a form of TMS using high frequency magnetic stimulation. TBS treatment is also used in depression and anxiety and the treatments are shorter than rTMS
- Transcranial Direct Current Stimulation (tDCS) is another treatment for depression that uses very small currents of electricity to stimulate the underlying brain
- Ketamine infusion - a low dose of ketamine is slowly administered using a syringe pump over 40 minutes, this helps with low mood but may not last more than a few days
- Electro Convulsive Therapy (ECT) a carefully measured electrical current is passed through the brain to alleviate symptoms of either depression, mania or catatonia.
- Opportunity to be part of research and wearing a Fitbit during treatment – You-Track project
Who is this service for? Adults aged 18 years and over.
Access how: Referral is via your GP or Psychiatrist.
AddressCentre for Neuromodulation , Berrywood Hospital, Berrywood Drive, Upton, Northampton, Northamptonshire, NN5 6UD
About our treatments
Repetitive Transcranial Magnetic Stimulation (rTMS)
Repetitive Transcranial Magnetic Stimulation (rTMS) is a treatment for adult patients with Clinical Depression. It provides a solution to those for whom antidepressant medications and psychological treatment have failed to provide satisfactory relief.
NICE approves the use of ground-breaking rTMS for the treatment of depression. NICE recommended guidance
Treatment with rTMS:
- An alternative to antidepressants
- Highly effective
- Pain free
Berrywood Hospital - is able to offer patients rTMS, a safe and ground-breaking treatment for Clinical Depression. The treatment uses magnetic stimulation to target the part of the brain that regulates mood. It is a very effective treatment that often succeeds when drugs have failed, as a method of reducing or eliminating the symptoms of Depression. It is a non-invasive and generally side-effect free treatment.
Ketamine infusion therapy
People who have been diagnosed with treatment resistant depression may be suitable for Ketamine Infusion Therapy. If a patient is not responding to inpatient therapy, medication, or other forms of treatment, ketamine infusion may be considered as the next step.
For more information about Ketamine infusion, please read the information sheet available here: Ketamin Infusion Therapy - patient information.
Contact us and referrals
Centre for Neuromodulation
Northampton, NN5 6UD
Telephone: 01604 685584
Mon-Fri: 07.00 - 16.00
ECT clinics, ketamine Infusion
Tues-Fri: Mornings only
Make a referral
Clinicians who want to refer patients for rTMS should first contact the Treatment Centre using the details above.
Prior to receiving rTMS, patients will be spoken to by the team’s Consultant Psychiatrist who will ask about their psychiatric and medical history.
At the end of this appointment patients will be informed if they are suitable to receive rTMS Therapy. For further information about rTMS or to discuss any aspect of the treatment, please contact the rTMS Treatment Centre.
Physio - the team
Professor Alexander O'Neill-Kerr
- Bipolar Disorder, runs a specialist clinic for complex Bipolar patients in Daventry.
- Lead consultant for ECT and related physical treatments in Psychiatry such as repetitive Transcranial Magnetic Therapy, Ketamine infusion and Light-box therapy for SAD
Prof O'Neill-Kerr has been the Trust's Medical Director since 2004 and is responsible for research and innovation, medicines management and clinical effectiveness and quality.
Reviews of our services and clinicians can be found via iWantGreatCare.org or by selecting the picture.
Dr Timothy Millward
His clinics are held at St Mary's Hospital, Kettering and his inpatient care occurs at Berrywood Hospital in Duston.
Reviews of our services and clinicians can be found via iWantGreatCare.org or by selecting the picture.
Louise Gell-Bean - Business Manager
Hello my name is Louise and I am a mum of two who has worked within NHFT for almost 10 years predominantly alongside, and with, the Medical Director. I have been involved in the set-up of the rTMS service since 2015 and was very proudly, appointed Business Manager for the Centre for Neuromodulation. I wear a number of different ‘hats’ but my favourite is the ‘Customer Service’ hat, which gives me the opportunity to engage with our patients and carers on a daily basis. My day to day workload is mainly background work, receiving and processing all referrals into the service from both internal and external sources. With this, I frequently liaise with other NHS Trusts, CCGs and private providers along with self-referring patients from out of area and it is my responsibility to ensure that we receive financial remuneration, from these sources, for the service we are providing. I organise rTMS training events, which are attended by external delegates from all over the country and we have even welcomed colleagues from New Zealand and Japan! I am always open to receiving questions and queries about the service so please do not hesitate to contact me if you wish to know more.
Abby Lovesy - ward matron
Hello I am Abby; a granddaughter, daughter, sister and mother to 3 beautiful girls not forgetting our doggy little boy. I have worked for NHFT for 24 years starting at the age of 15/16 with an after school canteen job. I qualified at the age of 21 and have practiced for the last 18 years. I have worked in a variety of roles from inpatients to, CPN, nurse specialist in ICT to senior clinical research nurse at Berrywood. Then I joined the Treatment Centre pulling on all my previous roles in this innovative area of practice. I am now the ward matron of Centre for Neuromodulation. I am clinical lead to a fantastic team who are dedicated to changing lives and going the extra mile every day. We are lucky to be part of this exciting treatment.
I have witnessed first-hand, on many occasions, the positive change this treatment can make (it still gives me goosebumps a year on). I see my role continuing to drive this service forward, looking at new ways and conditions we can treat whilst using the best evidence based research and continuing to provide excellent patient care with a commitment to making a difference for you, with you. I will support the team to develop and grow while still maintaining the smooth running of this busy area.
Frequently asked questions (FAQs)
Where and when will I have my rTMS?
rTMS is usually given at the centre at Berrywood Hospital on an inpatient or outpatient basis.
It is usually given once daily Monday to Friday.
The nursing staff will give you an allotted time for your appointment.
The treatment usually takes less than 40 minutes depending on the type of treatment you are prescribed.
For the first appointment it is advised that you have a relative, friend or carer accompany you.
What does the Treatment Procedure look like?
The non-invasive method of brain stimulation relies on electromagnetic induction using an insulated coil placed over the scalp, focused on an area of the brain thought to play a role in mood regulation.
The coil generates brief magnetic pulses, which pass easily and painlessly through the skull and into the brain.
The pulses generated are of the same type and strength as those generated by magnetic resonance imaging (MRI) machines.
Who administers rTMS treatment?
An rTMS doctor will prescribe your treatment.
The treatment itself is administered by an experienced rTMS technician who has had the required training to safely administer the treatment under the supervision of an rTMS nurse. The TMS technician will be with you during your treatment and can answer questions you may have.
The rTMS nurse will always be present in the Centre to monitor during treatment.
The patient can stop a treatment at any time by asking the staff member present.
Are there any special preparations before I have my rTMS treatment?
Yes. The treatment centre nurse will check your blood pressure, pulse and oxygen saturation levels prior to rTMS commencing.
You will need to remove any jewellery, including necklaces, earrings, face or tongue studs, hairgrips, mobile phone and debit / credit cards.
You can wear your own clothes. A short-sleeved or thin top is best so that the nurse can get an accurate blood-pressure reading.
There will be plenty of time to use the bathroom before your treatment if you need to.
What can I expect at my first appointment?
During the first rTMS session, some measurements are made using an Electroencephalography (EEG) Cap to ensure that the TMS coil will be properly positioned over your head. The coil will be placed on the area of the brain relating to mood or anxiety depending on your personal treatment plan. Treatment will then start.
During the treatment, you will hear a series of clicking sounds and will feel a tapping feeling from the magnet. The tapping may be continuous or come in bursts.
What happens during rTMS treatment?
A technician will stay with you throughout your treatment.
You will be introduced to other members of the team and asked:
- If you still consent to rTMS
- Concerns about the treatment
- Experienced any side effects.
During the course of treatment the doctor may need to reassess your progress and nurses may ask you to complete questionaires to measure improvement.
What happens after the rTMS treatment?
As rTMS does not require any sedation or general anesthesia, and patients are fully awake and aware during the treatment there is no “recovery time”. Some patients may feel tired after the treatment, this is normal and more likely with Theta Burst treatment.
If you attend as an outpatient you can drive home afterwards and return to your usual activities.
For the first appointment we recommend you have someone with you for additional support (i.e. family member, carer, nurse escort) you can have someone with you at any or all of the subsequent treatments
What are the side effects of rTMS?
rTMS is well-tolerated and associated with few side-effects.
The most common side-effect is discomfort at the treating site. This is usually mild and generally gets less noticeable over the course of the treatment. Over-the-counter pain medication can be used to treat discomfort if needed and can be taken half an hour before treatment.
Headaches can happen after the treatment over the counter pain medication can be used.
Sometimes people feel faint or dizzy during the treatment. This can happen at any time during treatment and the technician will discontinue treatment and lie you flat until you feel better. Treatment can usually continue the following day. This side effect is very uncommon.
There is a small risk of a seizure with this treatment but this is exceedingly low.
Can I eat or drink before my rTMS treatment?
Yes — rTMS does not need anaesthesia therefore you can eat or drink anything as normal.
Can I drive myself home afterwards?
If you do drive, you will need to speak to the Consultant Psychiatrist prescribing your treatment before you start a course of rTMS.
Generally most patients feel able to drive post treatment.
If you attend on an outpatient basis it is recommended for your first appointment you bring a relative, friend or carer for support.
Should I take my medication before having rTMS?
You should take your medication routinely as prescribed by your doctor unless otherwise specified by your doctor. Generally your mental health medication will remain unchanged during treatment. It may be that some medication can be stopped after a successful course, this will be done in consultation with your GP or psychiatrist. Most patients elect to continue antidepressants especially if it has made some difference to symptoms and where side effects are not too troublesome.
Can I change my mind?
Yes — We will ask you to sign a consent form before your course of rTMS starts.
You can withdraw your consent at any time. Detained patients under the Mental Health Act or patients lacking mental capacity are currently not considered for this treatment.
If you do withdraw your consent it is important to discuss your reasons for doing so with your doctor so that you can consider alternative treatments.
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Between 20-40% of people with depression do not recover following standard treatments such as medication and psychotherapy. Transcranial magnetic stimulation is a treatment used for adult patients with major clinical depression when antidepressants have repeatedly failed to control their symptoms. The American Psychiatric Association (2013) describe major depressive disorder as a medical illness that affects how you feel, think and behave causing persistent feelings of sadness and loss of interest in previously enjoyed activities. It can lead to a variety of emotional and physical problems and usually requires long-term treatment.
To make a referral please use the information on the 'Contact Us/ Referrals' tab
Transcranial magnetic stimulation (TMS) is a form of neuromodulation, a non-invasive, nonconvulsive technique used to stimulate neural tissue. The procedure involves placement of an electromagnetic coil to deliver a short powerful burst of magnetic field (1.5-2 Tesla) through the scalp to induce electric current in the brain. TMS is a relatively new treatment modality for psychiatric disorders but as been well established in neuroscience research experiments and in clinical application for neurological conditions. Additionally it has been used as an investigative tool in neuronal diseases.
The stimulation can be delivered either as a single pulse or repetitive pulse abbreviated as rTMS. The clinical utility of TMS treatment involves repetitive pulses applied in trains of stimulation over a target area over the cortical region of the brain. The response to the treatment is influenced by multiple factors such as stimulus frequency, intensity and duration and its ability to excite or inhibit particular neuron functions. The strength of magnetic field for clinical application is similar to that of a standard MRI scanner.
Putative mechanism of action
Like many other antidepressant treatments that are available in clinical practice, the exact mechanism by which rTMS produces relief from depression is still unknown. At a physiological level the effects of rTMS are frequently reported to be similar to long-term potentiation (LTP) or longterm depression (LTD) of stimulated neurons which in turn implicates changes in synaptic plasticity.
Synaptic plasticity is the ability of synapses to strengthen or weaken over time in response to increases or decreases in their activity. LTD and LTP are two forms of long-term synaptic plasticity that apply to a long-lasting experience-dependent change in the efficacy of synaptic transmission (i.e. amplitude of synaptic potentials).
They have been widely studied as they represent cellular correlates of learning and memory. However, invoking this mechanism to explain effects of rTMS is over simplistic hence needs further exploration. A number of studies indicate that large scale brain networks are altered in patients with depression, and the degree of the change in their connectivity predicts the severity of depression.
Repetitive stimulation of focal nodes of these networks can result in reorganisation of connectivity patterns in the brain due to brain’s inherent plasticity (use-dependent strengthening of existing pathways). Research suggests that rTMS indeed results in changes in regional brain activity and metabolism, and applying rTMS at the left dorsolateral prefrontal cortex (DLPFC) can enhance this region’s connectivity with other regions that are crucial for regulating emotional processing.
We hold training sessions for healthcare professionals throughout the year. Click here to download our training flyer and booking form for 2020: 2020 rtms training flyer.pdf [pdf] 523KB