1319 Punahou Street #1000 Honolulu, HI 96826
FAQ

MeRT FAQ

MeRT stands for Magnetic EEG-guided Resonance Therapy. MeRT is a treatment that combines technologies of repetitive transcranial magnetic stimulation (rTMS, an FDA cleared therapy), Quantitative Electroencephalogram (qEEG) and Electrocardiogram (ECG/EKG) to deliver treatments tailored for each individual’s unique brain pattern.

The patient’s qEEG and EKG are analyzed to determine the brain’s pattern of function and activity. The resulting information is used to develop a personalized treatment aimed at shifting brain connectivity to an individual’s ideal brainwave frequency, which can lead to significant clinical improvements.

rTMS therapy delivers a standardized treatment approach that uses the same protocol by stimulating the same location of the brain at a fixed frequency for all patients. MeRT delivers an individualized treatment protocol approach that varies in treatment location, treatment frequency, and intensity based on each patient’s quantitative EEG and EKG data.

As such, MeRT is a customized treatment approach that varies per individual. With MeRT, we identify the exact brain areas and levels of stimulation needed to safely and gently shift brain activity to each person’s unique, optimal brain frequency.  

At Synapse Hawai’i, we require a diagnosis for individuals seeking treatment for Autism Spectrum Disorder prior to starting MeRT. For all other conditions, a diagnosis is not necessary to start MeRT. However, we highly recommend all individuals receive diagnostic assessment and establish care with appropriate providers prior to starting MeRT. Our clinician is not meant to be any patient’s primary specialist for any condition.

Absolute contraindications for cortical MeRT treatment at Synapse Hawai’i:

  • Pacemaker
  • Defibrillator
  • Vagal Nerve Stimulator
  • VP Shunt/ Magnetic intracranial shunts
  • Deep Brain Stimulator
  • Epidural Cortical stimulator
  • Steel shunts/stents
  • Cranial metal fragments (i.e. shrapnel, excluding titanium)
  • Schizophrenia or history of psychosis (i.e. hallucinations, delusions)
  • Cochlear implant
  • Aneurysm clips, coils, pipelines flow diversion
  • Pregnant or breastfeeding
  • Primary brain cancer/metastatic lesions in brain (unless palliative care)
  • Magnetic dental implants
  • Implanted cardio-verter defibrillators (ICD)
  • Ocular implants
  • *Bipolar Disorder Type I/II
  • *Schizophrenia

*May be treated at other TMS/MeRT centers, but not at Synapse Hawai’i

Relative contraindications (requiring closer protocol attention, but not disqualifying someone from receiving cortical MeRT℠ treatment:):

  • History of Seizure or seizure disorder
  • Titanium shunts/stents
  • Spinal Cord Stimulator
  • Hearing aids
  • Ferrous cortical implants
  • Magnetic ink tattoo
  • Bipolar Disorder Type I/II
  • Baha Implant

We currently only provide qEEG, consultation, and treatment services related to MeRT. Diagnostic assessment and any other services are not available at this time.

Common benefits of MeRT include reduction of symptoms and behaviors interfering with daily functioning  and the following:

  • Better sleep
  • Increased sleep duration
  • Reduction of stress symptoms
  • Reduction of pain
  • Increased concentration and focus
  • Improvement in mood
  • Increased attention span
  • Increased sociability
  • Increased motivation
  • Improvement in clarity of thought
  • Decreased cravings (e.g. drugs and alcohol)
  • Increased emotional stability
  • Increased ability to adapt to change
  • Improved self-confidence and self-esteem

Results are individual in nature, depending on the initial presenting symptoms, and are not guaranteed. 

Side effects are few,  generally mild,  and short-lived. The most commonly reported side effect is a mild tension headache, which typically responds well to over-the-counter painkillers.

Other possible side effects are hyperactivity, fatigue, increased agitation, or euphoria. If side effects occur during treatment, inform your technician so that treatment may be adjusted accordingly.

With brain stimulation there is also a risk of seizures; however the risk is minimal (1: 100,000) with MeRT therapy. At Synapse Hawai’i, MeRT treatment protocols take into account past or present seizure activity to reduce the risk of seizure caused by treatment.

MeRT is painless and non-invasive. MeRT stimulation is accompanied by a clicking noise and often feels like light to firm tapping in the stimulation area. If any discomfort is reported by a patient, our technicians are trained to adjust treatment intensity accordingly.

Every individual’s response to treatment is different. We require every new patient to undergo a 2 week assessment period. Generally, most people experience some sort of benefit within the first 2-3 weeks of treatment.

We recommend that you continue taking your prescribed medications while receiving MeRT and do not add, stop, or change any medications while receiving MeRT to ensure accurate progress monitoring. Please inform our clinician of all medications you are taking prior to starting treatment and let your technician know if any changes in medication occur during treatment.

In general, the longer the length of MeRT therapy, the longer the changes remain. Majority of patients who complete at least 4-6 weeks of treatment report that most benefits are long lasting. However, results can vary per individual.

 

 

The changes to your brain and clinical benefits gained are generally long-lasting, especially if at least six weeks of continuous MeRT is completed. However, results can vary per individual.

Patients may choose to opt for additional treatment in the future if they wish to “refresh” benefits or pursue additional benefits.

After your initial consultation and baseline assessment of a qEEG and qEEG review, treatment is scheduled in 10 treatment session intervals.

Treatment sessions are once per day, five days per week (Monday through Friday), at the same time every day over the course of two weeks. Each treatment session lasts approximately 30-45 minutes.

A follow-up qEEG and qEEG review with the clinician is scheduled near the end of each 10 treatment period to monitor your progress and inform continued care.

It is recommended that individuals complete at least four to six consecutive weeks of MeRT in order to achieve maximum, long-lasting benefits.

We highly recommend that you pursue other modalities of treatment for you or your loved one’s condition in addition to MeRT. Best practice for most health conditions is a multimodal approach. MeRT combined with other interventions may increase clinical benefits.

Our office is in the Physicians Office Building in Kapiolani Women and Children’s Medical Center in Honolulu, Hawaii. We are located on the 10th Floor, Suite 1000. 

You may park in the Kapiolani Women and Children’s Medical Center visitor’s parking lot on Bingham Street. We validate parking for Synapse Hawai’i patients for up to 2 hours. 

Financial FAQ

Our patient coordinator can answer any questions about cost. They are available at 808-754-1027 or synapse@synapsehawaii.com.

At this time, the only insurance we take is Tricare, which covers rTMS, which MeRT employs, for Major Depressive Disorder.

Currently, rTMS, which MeRT employs, is FDA-cleared and typically covered by many health insurances for multi-medication resistant Major Depressive Disorder and Obsessive Compulsive Disorder in adults 18 years and older. Treatment for all other conditions is considered “off-label” and requires payment out of pocket.

Some patients reported that they were able to receive insurance reimbursement for qEEGs and qEEG Reviews depending on their health coverage. Also, some patients were able to use flex spending money to help pay for qEEGs and MeRT. If you would like to file for reimbursement from your insurance, we can provide you an itemized receipt to submit with your claim.

In general, it is highly unlikely that any insurance will provide reimbursement for MeRT for children or other conditions besides multi-medication resistant Major Depressive Disorder and OCD in adults. However, please contact your insurance if you have questions.

It is important to note that studies are currently underway. We are hopeful that treatment for Traumatic Brain Injury (TBI) and Post Traumatic Stress Disorder (PTSD) will be FDA cleared in the next few years. Studies for MeRT for Autism Spectrum Disorder among children is ongoing and will hopefully be FDA cleared in the distant future.

Acceptable forms of payment are cash ($) and major credit cards including Visa, MasterCard, American Express, and Discover. Full payment is collected before services are delivered. If you have any questions regarding payment, please contact our patient coordinator. They are available at 808-754-1027 or synapse@synapsehawaii.com.