The Emerging Uses of TMS: What the Evidence Shows So Far

Key takeaways

• Emerging uses of TMS range from off-label treatments supported by growing evidence to investigational treatments that are still being explored in clinical trials.
• Research suggests that TMS may be helpful for a number of neurological and mental health conditions, including stroke recovery, Alzheimer’s disease, and post-traumatic stress disorder (PTSD).
• Consider whether the device and protocol are FDA cleared, what evidence supports TMS for your condition, the benefits you can realistically expect, TMS side effects, and what insurance may or may not cover.

If you’ve tried standard treatments for a condition without getting the relief you hoped for, you might wonder whether an emerging treatment, such as transcranial magnetic stimulation (TMS), could help with your symptoms. TMS for depression is already well-established, but researchers are also exploring its use for a growing range of additional conditions.

Early studies show promising results, so there’s reason to be hopeful. However, it’s important to understand what “emerging” really means — and when it becomes a more routine part of care for a specific condition. Some uses are supported by clinical trials, while others are still being tested in small or early studies. Investigational uses are encouraging but should not be treated as proven simply because a clinic offers them or because early studies show potential benefits.

In this article, we’ll explore what “emerging uses” of TMS means, which conditions researchers are actively exploring, and how to tell whether an off-label treatment might be right for your needs.

What “emerging uses” of TMS actually means

"Emerging uses of TMS" means that the treatment is being trialed for conditions or patient groups beyond FDA-cleared uses, either in research studies or off-label. “In a rapidly-changing field such as TMS, there are also a lot of treatment options that are known to be effective, but are not FDA cleared,” explains Steve Harvey, MD, Midwest Regional Medical Director at Radial.

“Emerging” isn’t a formal FDA label, but it can describe treatments that are at various stages of study. That’s why, when looking at claims about TMS therapy, it helps to understand which category the use falls into.

• FDA cleared means that the FDA has cleared a specific TMS device to treat specific conditions in a specific population. “If a protocol has FDA clearance, then that ‘seal of approval’ is additional reassurance that the protocol is proven to be effective,” Dr. Harvey says. Although this does not guarantee a treatment will work or be covered by insurance, it offers the clearest regulatory support.
• Off-label uses of TMS are when providers use FDA-cleared TMS devices for conditions, populations, or protocols outside those outlined by the FDA. This means that treatment may be accessible, but the evidence supporting its efficacy may be less certain, and insurance coverage is less likely. 
• Investigational means researchers are still testing a treatment in clinical trials, so it hasn’t become part of routine care or off-label use yet. Access to experimental uses of TMS is typically limited to study participants, and questions remain about its benefits, risks, and side effects.

Another key point is that TMS clearance depends on the device and protocol. Different protocols, including accelerated TMS, may have different indications or levels of support, so clearance for one doesn’t necessarily apply to another. “Some protocols are not FDA cleared, but still known to be effective,” Dr. Harvey says. “Oftentimes, research and clinical experience have shown something to be effective, but the FDA just hasn't caught up with it yet.”

TMS treatment has already broadened in scope beyond its original clearance for major depressive disorder in adults. Specific devices are now cleared as an adjunct OCD treatment, as a short-term aid for smoking cessation for adults, and for the acute treatment of migraine pain with aura. TMS for teens can also involve some systems that are cleared to treat teen depression in people between the ages of 15 and 21. TMS for anxiety is also cleared for adults who have depression with comorbid anxiety.

Emerging uses of TMS in neurological conditions

TMS is being studied for its use in a number of neurological conditions, including Parkinson’s disease, Alzheimer’s disease, stroke, chronic pain, and tinnitus. “There is some surprising progress in using TMS for chronic pain, Parkinson's disease, and stroke rehab,” Dr. Harvey notes.

Because TMS can change activity in certain brain areas, researchers are interested in whether it might improve functions affected by neurological conditions, such as movement, memory, and pain.

Some of these uses have been studied more extensively than others, but none are currently FDA-cleared. For now, they remain investigational or may be offered off-label.

Parkinson’s disease

Parkinson’s disease affects brain regions associated with planning and controlling movement, and researchers are exploring how TMS might modulate activity in these regions. Research in Clinical Parkinsonism and Related Disorders suggests that targeting key areas with stimulation may help with symptoms such as slowed movement, tremor, stiffness, and difficulty walking. TMS might be helpful for non-motor symptoms, such as cognitive problems and depression.

Current research has already moved beyond the early stages. A review of clinical studies published in Neurological Sciences suggests that repeatedly stimulating motor-related brain regions may improve overall motor function, balance, and mobility.

A 2025 review in PLoS One concluded that while promising, TMS for Parkinson’s needs further studies to standardize treatment protocols and compare it with other treatments. It’s also important to recognize that no evidence shows it slows or reverses the condition. For now, TMS is best viewed as a promising potential add-on treatment and not a stand-alone or established therapy for Parkinson’s disease. 

Alzheimer’s disease and cognitive decline

By targeting brain networks associated with memory, language, and thinking, repetitive TMS may help people with Alzheimer’s disease and mild cognitive decline. 

The current research is promising. A 2026 review in Neuroscience and Biobehavioral Reviews found that rTMS might lead to short-term improvement in thinking, memory, and language for people with Alzheimer’s. Another review in Frontiers in Neurology found possible benefits for verbal memory and some executive functions for people with mild cognitive impairment.

What’s still unclear is how long the benefits of TMS for Alzheimer’s last and whether they help with day-to-day functioning. rTMS has also not been shown to slow the disease’s progression and no TMS device is cleared for the treatment of Alzheimer’s and mild cognitive impairment.

Stroke recovery

Researchers are also exploring rTMS to support the brain’s ability to reorganize and form new connections after a stroke. A stroke disrupts activity on both sides of the brain, so TMS may be used to increase activity on the injured side or calm the unaffected side. It’s typically paired with speech, occupational, and physical therapy rather than being used on its own.

A 2023 review in Stroke found that rTMS may improve some motor, language, attention, and cognitive outcomes. Newer research in Systematic Reviews suggests that rTMS may help improve motor function after a stroke, particularly during the first six months of recovery. While research in Life suggests that the evidence for TMS for stroke recovery is promising (especially for attention and executive functioning), rTMS isn’t yet a standard part of stroke rehabilitation. 

Chronic pain and tinnitus

Because it can influence brain areas involved in how we perceive pain and sound, TMS is also being explored as a potential treatment for chronic pain and tinnitus, especially when standard treatments haven’t provided enough relief.

TMS may help relieve symptoms of neuropathic pain, which is caused by nerve disease and damage. A 2025 review in The Lancet Neurology supports using rTMS as a third-line treatment for neuropathic pain, which means it's usually considered after more established options haven’t been effective enough. The long-term benefits are still unclear, and the FDA has not cleared it for chronic pain, although some devices are cleared for migraine pain relief, Current Pain and Headache Reports explains.

Research on TMS for tinnitus is more mixed and remains investigational. A meta-analysis published in Frontiers of Neuroscience suggests there may be some short-term improvements, but a 2026 review of clinical trials in The Laryngoscope found that rTMS was no more effective than sham treatment.

Emerging uses of TMS in mental health and behavioral conditions

TMS is also being explored as a treatment for other conditions, including substance use disorders and bipolar depression. “The near future is likely to see some new TMS indications for PTSD, anxiety, and substance abuse disorders,” Dr. Harvey explains. Evidence for each use varies, but most are still investigational. Promising early results don’t mean that a treatment is ready to become part of routine care for a specific condition.

PTSD

Standard TMS for PTSD (post-traumatic stress disorder) isn’t FDA-cleared, but one specific type of TMS gained FDA clearance in 2026: Magnetic e-Resonance Therapy (MeRT). MeRT uses EEG recordings of a patient’s brain activity to personalize the magnetic stimulation protocol. According to the developer Wave Neuroscience, treatment led to a 52% reduction in PTSD symptoms and 68% remission.

Beyond MeRT, researchers are actively exploring the efficacy of standard TMS for PTSD treatment. They're studying its use both alone and in combination with trauma-focused therapy to reduce symptoms like intrusive memories, avoidance, and sleep problems. Stimulation may help make the brain more receptive to learning as a person works through trauma-related thoughts and memories. An observational study published in Brain Stimulation found that TMS led to substantial reductions in PTSD symptoms.

Substance use disorder and addiction

Researchers are also investigating TMS for substance use disorder — and other addictive disorders such as gambling and sexual addiction — to see whether targeting areas of the brain associated with reward and control can help reduce cravings and withdrawal symptoms. Its use is most often studied as a tool alongside medication, peer support, and other treatments.

A review in Neuropsychopharmacology suggests that rTMS sessions may help reduce cravings or use for some people, but it isn't clear whether this can lead to lasting change or reduce the risk of a person returning to use. 

Research has explored the use of TMS for substance use disorder involving alcohol, nicotine, cocaine, cannabis, opioids, and methamphetamine, but it is not yet cleared for such uses. Smoking cessation is the exception: the FDA has cleared a specific deep TMS device as an aid in short-term smoking cessation. That clearance doesn't apply to other substance use disorders.

Bipolar depression

TMS is sometimes used off-label for bipolar depression, although it is not FDA cleared for the condition. A 2025 systematic review in Biological Psychiatry Global Open Science says that TMS could be effective for improving bipolar depression symptoms.

Other areas of study

• Autism: Small studies have explored whether TMS may help with executive functioning, repetitive behaviors, and other challenges. A 2025 review in Research in Developmental Disabilities found possible benefits, but the studies were small and used different TMS protocols.
• Schizophrenia: TMS may also help symptoms of schizophrenia, but the evidence supporting its use varies depending on the symptoms and the protocol that is used. A meta-analysis published in Psychiatry Research found that there may be some benefits for negative symptoms of schizophrenia, such as reduced motivation. Clinical trial research published in JAMA Network Open suggests that it may help with auditory hallucinations. However, TMS is not yet established as a go-to treatment for schizophrenia.
• Eating disorders: Early findings suggest that TMS may help with food-related urges and eating disorder symptoms. However, a 2026 review in Annals of General Psychiatry found that its effects on weight restoration and eating behavior are still unclear.
• Elite athletic performance enhancement: Beyond disease treatment, TMS is also being explored for its potential to enhance athletic performance, particularly in elite athletes where small gains offer competitive advantages. Research in Frontiers in Human Neuroscience suggests that brain stimulation, including TMS, may support improved coordination, fine motor skills, and injury recovery.     

Some clinics promote TMS for uses with less support as if they are already firmly established. “Occasionally we see questionable practices being promoted, including for conditions where there is little evidence that TMS is beneficial or using a protocol that has little or no evidence of effectiveness,” Dr. Harvey notes. “This is something to watch out for. Sadly, these practices are often accompanied by slick advertising featuring persuasive testimonials.”

Before considering TMS for an off-label or non-established use, ask whether the specific device and protocol are FDA-cleared for the condition and what research supports its use for other conditions and populations. 

Can you get TMS for an emerging use right now?

For most emerging uses of TMS, access is mostly available through clinical trials and research studies, although some clinics may offer it off-label for some conditions. Brain Stimulation suggests that the most common off-label uses promoted by TMS clinic websites include anxiety/panic attacks, PTSD, bipolar disorder, substance use disorder, and pain/fibromyalgia.

If you’re interested in trying TMS for a condition still being studied, start by talking with a specialist who treats it. You can also search ClinicalTrials.gov or ask your clinician about studies that are recruiting in your area. 

“When someone is evaluating a possible treatment that is not FDA-approved, my first bit of advice is to talk to the TMS provider and ask them to tell you more about the evidence for that particular treatment,” Dr. Harvey suggests.  “Get that information from the provider, not from a salesperson, a manager, or an online advertisement.”

Whether insurance covers TMS is another important consideration since it usually will not cover investigational or off-label uses. “FDA-cleared protocols will have a better chance of being covered by insurance so that they're likely to have less out-of-pocket cost,” Dr. Harvey says. This means you may be responsible for paying the full cost of treatment out of pocket. Coverage rules also vary according to your specific plan, diagnosis, and treatment protocol. 

If you are unsure if TMS might be right for you, we can help you understand what TMS can treat at Radial and whether TMS, a clinical trial, or another treatment option makes the most sense for your situation.

The bottom line

TMS research continues to indicate promising new uses, but the evidence depends on factors like the specific condition, protocol, and device. A promising result in one area doesn’t automatically carry over to treating another condition. Some emerging uses have enough research to support a conversation with a provider about whether you might want to try TMS. Others are still in the early stages and need more research to better understand how they work. 

If you are considering TMS for a condition outside the currently cleared uses (which include major depressive disorder, major depressive disorder with anxious features, migraine, smoking cessation), approach it with curiosity and a few good questions. Talk to a provider about what’s been studied so far, what you can realistically expect, and what other treatments may also be part of your plan.

Frequently asked questions (FAQs)

Is it safe to try TMS for a condition it's not approved for?

Off-label TMS can be appropriate for some people, but safety and potential risks depend on factors like your medical history and the condition being treated. Your provider will consider your specific situation to determine whether TMS is right for you.

How can I find a clinical trial for TMS?

Search ClinicalTrials.gov for ‘TMS’ or ‘transcranial magnetic stimulation’ and the name of your condition, then filter for studies that are currently recruiting for study participants. You can also ask your provider whether nearby medical centers or universities are enrolling participants.

Does insurance cover off-label or investigational TMS?

No, insurance does not usually cover off-label or investigational use of TMS. Coverage is usually limited to specific diagnoses and treatment protocols, so off-label TMS is often paid out of pocket. While FDA-cleared uses are more likely to be covered, Dr. Harvey notes that some FDA-cleared protocols are not covered.