BrainsWay Deep TMS uses a patented H-coil instead of the figure-eight coil most TMS machines use, which lets it reach measurably deeper into the brain without raising stimulation intensity to uncomfortable levels. Published research measuring the two coil types directly found the H-coil produces an effective field at depths of 4 to 5 centimeters, compared to about 1.5 centimeters for a standard figure-eight coil. Depth comes with a tradeoff: the H-coil’s field is also wider, reaching more of the target region rather than a narrow, focused point.
Here is what that difference actually means for how treatment works, and what it doesn’t mean.
What Is BrainsWay Deep TMS?
Deep TMS is an FDA-cleared, non-invasive treatment that uses magnetic pulses to stimulate specific brain regions involved in depression, anxiety, OCD, and other conditions. Resiliency’s Deep TMS therapy uses BrainsWay’s system, which was cleared following a large double-blind, placebo-controlled multicenter study and is distinct from the earlier generation of TMS devices built around figure-eight coils.
BrainsWay’s Deep TMS platform holds FDA clearance for several specific indications beyond depression, including obsessive-compulsive disorder and smoking cessation, each using a differently shaped H-coil tailored to the brain regions involved. The H1-coil used for depression is a different coil than the one used for OCD treatment, reflecting how the H-coil approach is built around targeting specific, deeper structures rather than being a single generic device.
At Resiliency, Deep TMS is one of three interventional options alongside Spravato and medication management, not a stand-alone service offered in isolation. A provider determines which option, or combination of options, fits a patient’s history during an evaluation, the same evaluation process used across all of the practice’s interventional services.
Deep TMS is available in two timelines at Resiliency: a standard course delivered once daily over several weeks, and an accelerated protocol (SWIFT) that compresses the acute phase into six half-days. Both use the same underlying H-coil technology described below. The choice between them is mostly about scheduling and time commitment, not about which one “works better,” a distinction covered in more depth in Resiliency’s companion piece on the accelerated protocol.
Patients weighing the technical differences described below against real-world results can see Resiliency’s published Deep TMS outcomes directly, rather than relying on coil specifications alone.
At Resiliency, Deep TMS is most often used for treatment-resistant depression, though the underlying FDA clearance also covers OCD. Patients considering Deep TMS for either condition go through the same evaluation process, since the clinical criteria and treatment planning both depend on a provider’s assessment of symptom history and severity, not a generic protocol applied the same way to everyone.
Patients sometimes assume “Deep TMS” and “TMS” are two names for the same thing. They’re related but not identical: Deep TMS refers specifically to treatment delivered with an H-coil, built to reach deeper brain structures than the figure-eight coils used in standard, first-generation TMS machines.
Patients deciding between a standard and accelerated schedule, or wondering whether Deep TMS is the right fit alongside Spravato or medication management, can call (949) 996-5355 or reach out through Resiliency’s contact page to talk it through with the clinical team.
What Is an H-Coil, and Why Does the Shape Matter?
The H-coil is a patented coil design, shaped differently from the figure-eight coils used in standard TMS machines, built specifically to project a magnetic field deeper into the brain without needing extreme stimulation intensity to get there. Published electric field research directly comparing the two coil designs found the H-coil reaches measurably deeper than a standard coil while also distributing the field more broadly.
| Standard figure-eight coil | BrainsWay H1-coil | |
|---|---|---|
| Shape | Two overlapping circular loops | Patented H-shaped winding pattern |
| Effective stimulation depth | About 1.5 cm | About 4 to 5 cm |
| Field distribution | Narrow and focal | Wider, covering more of the target region |
| Intensity needed for depth | Would require extreme, impractical levels | Reaches depth at standard, safe stimulation levels |
That depth-versus-focus tradeoff is deliberate, not a side effect. A narrow, shallow field is easier to aim precisely at one small spot. A wider, deeper field reaches more of a target brain region at once, which matters because the regions associated with depression and OCD aren’t single pinpoint locations. They’re distributed across an area a narrow coil can easily miss entirely.
The shape isn’t a marketing detail layered on top of ordinary TMS. It’s the specific design choice that makes Deep TMS a distinct category from standard TMS in the first place, not just a brand name for the same technology.
How Is Deep TMS Different From Figure-Eight TMS?
Researchers measured the electric field produced by figure-eight and H-coils directly in a realistic head model, rather than estimating it from clinical outcomes alone. The published findings are consistent across several studies:
- At a standard stimulation intensity, the H1-coil produces a suprathreshold field at depths of 4 to 5 centimeters in lateral and medial frontal regions
- A standard figure-eight coil’s field stays suprathreshold only to about 1.5 centimeters, concentrated under the center of the coil
- The H-coil’s field strength decreases far more slowly with distance than the figure-eight coil’s does, which is the underlying reason it can reach deeper structures without needing dangerously high intensity
- The H-coil design was first validated in a 2005 study against a standard coil in healthy volunteers, confirming the depth difference without raising safety concerns
This isn’t a difference in degree. Figure-eight coils were designed for a different purpose: precise, shallow stimulation of a specific, easily localized cortical target. The H-coil was designed around the opposite problem, reaching brain structures that sit deeper than a narrow coil can access at any safe intensity. Depression and OCD treatment targets tend to fall into the second category, which is part of why Deep TMS cleared the FDA for these specific indications using H-coil technology rather than a modified figure-eight design.
Why the extra width matters clinically, not just physically: research on the brain circuits involved in depression points to prefrontal cortex structures with extensive connections to the subgenual cingulate, a region implicated in mood regulation. Because those connected structures aren’t confined to one small point, a wider field has a better chance of reaching the full circuit involved, rather than a narrow field that could miss relevant tissue a few millimeters away.
Neither coil design is inherently “better” for every application. A figure-eight coil remains appropriate for research and clinical applications targeting a precise, superficial location. The comparison that matters for depression and OCD treatment specifically is depth of the actual target structures, and on that measure, the published data is direct: H-coils reach them, and standard figure-eight coils largely don’t.
Do I Need an MRI Before Starting Deep TMS?
No. BrainsWay Deep TMS doesn’t require an MRI or neuronavigation equipment to plan or deliver treatment, unlike some competing TMS systems that use brain imaging to guide coil placement for each individual patient.
Those MRI-dependent approaches generate a personalized map of a patient’s brain anatomy to guide where the coil is positioned for each session. BrainsWay’s motor-threshold approach skips that imaging step entirely, relying on a physiological response rather than an anatomical map to calibrate treatment.
Instead, treatment is calibrated using a motor threshold measurement: the lowest stimulation intensity needed to produce a small, visible physical response, typically a twitch in the hand. That measurement, taken at the start of treatment, is used to set the stimulation intensity for a patient’s sessions, personalizing the dose without requiring a scan of the patient’s brain.
This question comes up most with patients who have already done some research. Some have read about MRI-guided TMS. Others have contacted other clinics and been told an MRI is needed for the best results. As Dr. Stefani LaFrenierre, Resiliency’s founding psychiatrist, describes it:
“BrainsWay has a unique patented coil that targets the neural network involved in depression and anxiety, which means we don’t need an MRI to treat one specific depression spot like traditional figure-8 coils. Instead, we can target and treat a larger area of the brain, with significantly improved results when compared to traditional TMS.”
Patients who want to see how Deep TMS has performed in practice can review Resiliency’s published Deep TMS outcomes.
This matters practically, not just technically. An MRI-guided protocol adds a scan, a referral step, and often a wait before treatment can begin. Skipping that step means Deep TMS can start sooner after an evaluation, and it removes a cost and scheduling barrier that MRI-dependent protocols carry.
It also means coil placement follows a standardized, repeatable process rather than a custom imaging workup for every patient, which is part of why Deep TMS has scaled into widespread outpatient use rather than remaining limited to centers with neuroimaging infrastructure on site.
Does Deep TMS Hurt?
Most patients describe Deep TMS as uncomfortable rather than painful, particularly during the first session or two before the sensation becomes familiar. The most commonly reported effect is scalp discomfort or a mild headache at the treatment site, which is typically temporary and tends to lessen as a patient continues through a course of treatment.
Deep TMS doesn’t require anesthesia or sedation. Patients remain awake and alert throughout a session, can hold a conversation with the clinical team, and are able to drive themselves to and from appointments, a meaningful difference from Spravato, which requires monitored recovery time and no driving on treatment days.
The sensation itself is a tapping or clicking feeling at the scalp where the coil sits, caused by the magnetic pulses, rather than any kind of invasive sensation. Some patients notice jaw or facial muscle twitching during stimulation, depending on the exact area being targeted, which is expected and not a sign of a problem.
Patients with a lower tolerance for repetitive tapping sensations sometimes find the first few sessions more noticeable than later ones, which is consistent with what’s reported broadly for TMS treatment generally. This is different from a medical contraindication. Discomfort tolerance is a comfort question the clinical team can work through, not a safety reason to avoid treatment on its own.
Tolerance to the sensation generally improves across a treatment course. A patient’s first session is usually the most noticeable, and most people adjust within the first several visits, which is part of why Resiliency’s clinical team stays present throughout early sessions specifically.
How Long Is a Single Deep TMS Session?
A standard Deep TMS session runs about 10 minutes. Patients typically attend sessions five days a week for about six weeks, then taper to two days a week for three more weeks, for a standard course of 36 sessions over roughly nine weeks total.
Resiliency also offers an accelerated protocol that delivers the same H-coil technology on a condensed schedule: five sessions a day, each about nine minutes, across six half-days over two weeks, followed by weekly follow-up visits. The technology and the stimulation target are identical between the two options. What differs is pacing, covered in full in Resiliency’s companion piece on the accelerated protocol rather than repeated here.
Either way, a single session itself is brief relative to the overall course. Most of the time commitment in standard Deep TMS comes from the number of visits spread across weeks, not the length of any individual appointment.
Both Newport Beach and San Juan Capistrano offer standard and accelerated Deep TMS, so scheduling around either office depends mainly on which location fits a patient’s week, not a difference in which protocol is available where.
Frequently Asked Questions
What is BrainsWay Deep TMS?
An FDA-cleared, non-invasive treatment that uses a patented H-coil to stimulate brain regions involved in depression, anxiety, and OCD. It’s distinct from standard TMS, which uses a figure-eight coil and reaches shallower depths.
Do I need an MRI before starting Deep TMS?
No. Treatment is calibrated using a motor threshold measurement rather than brain imaging, so there’s no scan or imaging referral required before starting.
What conditions does BrainsWay Deep TMS treat?
Deep TMS holds FDA clearance for major depressive disorder and obsessive-compulsive disorder, among other indications, using differently shaped H-coils for each. At Resiliency, it’s most commonly used for treatment-resistant depression.
Does Deep TMS hurt?
Most patients describe it as uncomfortable rather than painful, especially in the first session or two. The most common effect is temporary scalp discomfort or mild headache, and no anesthesia or sedation is required.
How long is a single Deep TMS session?
A standard session runs about 10 minutes, typically five days a week for six weeks, then two days a week for three more weeks. An accelerated option compresses the same technology into six half-days over two weeks.
Patients can call (949) 996-5355 or reach out through Resiliency’s contact page to schedule an evaluation or ask about Deep TMS directly.