As premier hospital for diabetic neuropathy in Mumbai, our dedicated team of endocrinologists, neurologists, and rehabilitation specialists offers advanced treatments and personalized care plans to alleviate symptoms and promote overall well-being. At RNR Medicine, we prioritize your comfort and actively involve you in your diabetes care journey. Rediscover hope and a healthier, symptom-free future with RNR Medicine.

Diabetic Neuropathy is a diabetic complication that leads to nerve damage. Around 50% of the patients with severe diabetes experience this disease. It is characterized by pain, paresthesia, and late-stage complications, such as sleep deprivation, depression, foot ulcers, hemorrhage, motor function decline, and even amputation. A high incidence of these complications increases the risk of death and takes a heavy toll on the quality of life of the patient. Although painful neuropathy responds to antidepressants, anticonvulsants and opioid agonists, these drugs are often ineffective or can induce severe adverse effects

In many areas of the world, dedicated research is ongoing that can help patients to reduce their suffering from disability. Transcranial magnetic stimulation is such a novel innovative method that has shown promising results in recent studies. It is a painless, noninvasive method that modulates cortical excitability.

• Diabetic neuropathic pain is mostly burning, stinging or tingling type (like electric shock) and it may be spontaneous or provoked. It may impair the individual functionality and quality of life.
• Depression may be associated with painful or painless neuropathy. TMS has shown supporting results in many trials as a treatment for depression associated with diabetic neuropathy.
• Even patients with pregnancy, hypertension, diabetes, thyroid disorders, kidney diseases, heart diseases etc. can take part in this treatment.
• Medical devices which are commonly used now-a-days like stents, pacemakers, coils, orthopedic implants etc. are usually MRI compatible so they usually do not interfere with the TMS.

TMS has been researched around the world since about the 1980s. Lots of literature has been published so far in peer-reviewed journals on TMS with positive outcomes and negligible adverse effects. Hereby, we are mentioning one of the significant studies on TMS on Diabetic Neuropathy.

A study in Europe explored the effect of  deep TMS stimulation over the motor- cortical lower limb areas. 25 patients took part in 20 minute dTMS sessions for 5 consecutive days and it was seen that they achieved relief in pain in lower limb areas. No adverse effects were observed. This showed the effect of dTMS when targeting specific brain regions.

Method

• TMS is a non-invasive way of Neuromodulation.
• It involves low energy magnetic stimulation of the particular site of the brain through the skull
• This is delivered through a specially designed coil, incorporated in a helmet.
• When the patient comes in, the nurse will take a detailed history and update the doctor. The doctor will thereafter discuss the most suitable protocol with the patient, which will include the duration of each sitting, the frequency of sittings/week and the total no. of sittings.
• Once all confirmed, this will be fed in the computer
• Following this, necessary evaluation is done to determine the MT (Motor threshold) by imparting stimulation through the helmet.
• Based on the predesigned protocols, TMS will be administered to the patient.
• The procedure does not require any sedation or anesthesia. Patient is not required to keep fasting before the procedure.

The Jaslok Hospital & Research Centre is one of the oldest tertiary care, multi-specialty Trust hospitals in the country. Jaslok Hospital has research activities ongoing in various fields in collaboration with other institutions in India & abroad. The hospital has a dedicated “Restorative and Regenerative Medicine” department including consultants in various fields with more than 20 years of experience.

The department has procured the state-of-art technology and equipment from internationally reputed and trusted “Brainsway” company. It contains the advanced technology of  H1-7 coils instead of conventional coils, that can deliver noninvasive deep TMS in precise manner to get maximum result. It has FDA and CE clearance for treatment of various neurological and psychiatric conditions. The conventional TMS can only deliver specific target sites, limiting their use and capabilities. Deep TMS can reach the following target sites; insula, cingulate gyrus, etc.