rTMS: How It Supports Neural Connections
Transcranial magnetic stimulation (TMS) is a non-invasive method to stimulate the brain—without surgery—that has gained attention for helping strengthen neural connections and improve brain function. In this article, we explain how TMS works, how it affects brain tissue and networks, and why it may help promote neural connections and brain plasticity. The language remains accessible and avoids overly technical jargon.
What TMS Is and How It’s Applied
The term TMS refers to a technique in which a magnetic coil is placed on or near the scalp and generates a changing magnetic field that passes through the skull and induces an electrical field in the underlying brain tissue (Klomjai et al., 2015). Because the brain is surrounded by bone and skin, these magnetic pulses penetrate the barriers and activate nerve cells (neurons) without surgery.
Repetitive Transcranial Magnetic Stimulation (rTMS) repeats pulses many times in a session, producing longer-lasting effects. According to clinical guidance, a coil placed against the scalp delivers magnetic pulses that target brain regions involved in mood, attention, or motor control (Lefaucheur et al., 2019).
The Physical and Cellular Mechanism
At the most basic level, a TMS pulse works via electromagnetic induction—the changing magnetic field induces an electric current in the brain, exciting neurons or changing their responsiveness (Fitzgerald et al., 2006). When neurons within the field are activated, they send signals across axons and synapses. Most neuronal axons become electrically excited, trigger action potentials, and release neurotransmitters into postsynaptic neurons.
Beyond this immediate activation, rTMS promotes long-term changes by altering excitability and plasticity (Peng Z et al., 2018). Two key processes are:
Long-term potentiation (LTP): strengthening of synapses so that the same input produces a larger response.
Long-term depression (LTD): weakening of synapses to prune unused connections and improve efficiency.
By repeating pulses at specific frequencies, rTMS guides the brain’s plasticity toward more efficient network connectivity.
Additionally, rTMS can increase dopamine levels and influence neurotrophic factors that promote neural growth (Peng Z et al., 2018). These molecular changes—such as gene expression and enzyme activity—help maintain lasting improvements in neural communication (Lefaucheur et al., 2019).
How TMS Promotes Neural Connections and Network Health
TMS can target specific brain areas and their related circuits. In psychiatric treatments, for example, coils are placed over the dorsolateral prefrontal cortex (DLPFC) to influence mood-related networks (Lefaucheur et al., 2019). Stimulating one node in a network can affect broader connections and enhance overall communication between brain regions (Chail A et al., 2018).
Because repeated stimulation produces long-lasting effects, rTMS induces neuroplastic adaptation that reorganizes networks, strengthening existing connections and forming new ones (Klomjai et al., 2015). In neurological disorders—such as stroke or Alzheimer’s disease—TMS may help repair networks by reactivating underused pathways and enabling reorganization (Lefaucheur et al., 2025).
Why the “Connection” Angle Matters
Neural connections are the pathways that allow neurons to communicate. Stronger and more efficient connections mean better brain performance—faster processing, better regulation of mood and movement, and stronger cognitive control.
TMS supports this by stimulating axons, driving synaptic change, influencing neurotransmitter levels, and improving network communication (Chail A et al., 2018). Because many disorders—such as depression or brain injury—disrupt connectivity, a technique that restores communication within neural networks holds great potential.
Practical Notes on TMS Use
A typical TMS session involves placing a coil on the scalp and delivering magnetic pulses for several minutes. Parameters such as coil type, intensity, and frequency determine whether neural activity is increased or decreased (Fitzgerald et al., 2006).
High-frequency stimulation (>1 Hz): tends to increase cortical excitability.
Low-frequency stimulation (<1 Hz): tends to reduce cortical excitability.
TMS is generally considered safe when proper screening rules are followed—for example, avoiding patients with metallic implants or seizure risks (Lefaucheur et al., 2019).
Limitations and Open Questions
Despite its promise, TMS has limitations. Not all circuits respond equally, and personalization of coil placement and stimulation parameters remains challenging (Lefaucheur et al., 2025). The biological mechanisms behind long-lasting effects are not yet fully understood, and not every patient benefits to the same extent (Chail Aet al., 2018). Continued research aims to refine these protocols for more consistent outcomes.
Conclusion
Transcranial magnetic stimulation is a powerful tool for promoting neural connections and overall brain network health. By using magnetic pulses to stimulate neurons and circuits, TMS triggers synaptic plasticity, supports neurochemical and structural changes, and helps the brain rewire and strengthen its connections. As research advances, TMS will likely become even more precise and effective in restoring healthy neural communication.
References
Fitzgerald, P. B., Fountain, S., & Daskalakis, Z. J. (2006). A comprehensive review of the effects of rTMS on motor cortical excitability and inhibition. Clinical Neurophysiology, 117(12), 2584–2596.
Klomjai, W., Katz, R., & Lackmy-Vallée, A. (2015). Basic principles of transcranial magnetic stimulation (TMS) and repetitive TMS (rTMS). Annals of Physical and Rehabilitation Medicine, 58(4), 208–213.
Lefaucheur, J. P., Aleman, A., Baeken, C., Benninger, D. H., & Brunelin, J. (2019). Transcranial magnetic stimulation. Handbook of Clinical Neurology, 160, 559–580.
Lefaucheur, J. P., et al. (2025). Therapeutic potential and mechanisms of repetitive transcranial magnetic stimulation in Alzheimer’s disease. European Journal of Medical Research.
Chail A, Saini RK, Bhat PS, Srivastava K, Chauhan V. Transcranial magnetic stimulation: A review of its evolution and current applications. Ind Psychiatry J. 2018 Jul-Dec;27(2):172-180. doi: 10.4103/ipj.ipj_88_18. PMID: 31359968; PMCID: PMC6592198.
Peng Z, Zhou C, Xue S, Bai J, Yu S, Li X, Wang H, Tan Q. Mechanism of Repetitive Transcranial Magnetic Stimulation for Depression. Shanghai Arch Psychiatry. 2018 Apr 25;30(2):84-92. doi: 10.11919/j.issn.1002-0829.217047. PMID: 29736128; PMCID: PMC5936045.
