TMS Articles
Learn more about different aspects of accelerated fMRI-guided TMS. See if treatment can help you live the life you want to live.
One-Day TMS: An Accelerated Option for Treatment-Resistant Depression
One-D fits a full course of TMS into a single day at our clinic in Provo, Utah. We scan your brain with fMRI first, then aim 20 short theta-burst sessions at the target we find, one every 30 minutes over about 10 hours. It costs $3,000, which covers your fMRI scan and the treatment day, and a $600 deposit holds your date.
Not sure if treatment is right for you? Call our patient care coordinator at:
(385) 332-3908
What is One-Day (ONE-D) TMS and How Does it Work?
- Latest Development in Accelerated TMS: The ONE-D (Optimized, Neuroplastogen-Enhanced techniques in Depression) regimen, first described by Vaughn and colleagues in 2024, is designed to make TMS treatment faster, more affordable, and accessible. It is given off-label: the TMS device is FDA-cleared, but the one-day schedule is not.
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Accelerated Full Course: ONE-D delivers a patient's entire course of Transcranial Magnetic Stimulation (TMS) therapy, which conventionally takes weeks of visits, in a single day of about 10 hours.
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Intensive, Spaced Sessions: The single-day treatment involves 20 sessions of high-intensity, 3-minute intermittent Theta-Burst Stimulation (iTBS), the iTBS pulse pattern also studied in Stanford's SAINT research, with sessions repeated every 30 minutes to allow for brain recovery and maximal plasticity.
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Neuroplastogen Enhancement: The protocol is "Neuroplastogen-Enhanced," with a single pre-treatment dose of up to two medications, D-cycloserine and lisdexamfetamine (Vyvanse), to enhance the brain's ability to change (neuroplasticity) and improve the treatment's effect.
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Targeting: The study involved targeted stimulation at the posterior left Dorsolateral Prefrontal Cortex (DLPFC) using a non-personalized, scalp-based method. At Cognitive FX, we use a personalized target based on each patient's own fMRI scan. No study has tested that combination with the one-day schedule yet.
How our One-D day differs from the published protocol
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Personalized Targeting: Standard TMS uses skull measurements to estimate where your brain's depression-related circuits should be, similar to how a tailor might use standard sizing. But just like everyone's body is different, everyone's brain connectivity is unique. fMRI-guided TMS maps your specific brain architecture before treatment, identifying the exact spot in your prefrontal cortex that shows the strongest connection to your depression networks.
DISCLAIMER: SAINT™ is a trademark of The Board of Trustees of the Leland Stanford Junior University (“Stanford”) and has exclusively licensed such mark to Magnus Medical. Cognitive FX is neither endorsed by Stanford nor utilizes Magnus Medical equipment nor claims to be offering the SAINT protocol as prescribed by Stanford University et. al. or Magnus Medical. We provide fMRI guided intermittent theta burst TMS with target locations determined by fMRI and our prescribing physician.
What the research shows so far
The one-day regimen was first described in 2024, in a review of 32 patients' charts at two private clinics (Vaughn et al.). A review of 8 patients in a primary care office followed in 2025 (Nanos). Neither study had a control group.
The Clinical TMS Society said in December 2025 that this evidence is preliminary and not yet enough to recommend one-day TMS over better-studied options. Read the statement.
Our version differs from the published one. We aim every session with your own fMRI scan, while the published studies used a scalp-based target. No study has tested that combination yet.
How ONE-D TMS is different from rTMS and SAINT TMS
1. How long does ONE-D TMS take compared to the different treatment options?
Conventional repetitive TMS (rTMS) is a proven treatment, but it often takes dozens of clinic visits over four to six weeks. ONE-D condenses the full course into a single 10-hour day (20 sessions, one every 30 minutes). That can make treatment workable for people who live far from a clinic, have trouble getting around, or can't take weeks off work for daily appointments.
2. How does ONE-D differ from other accelerated protocols like SAINT TMS?
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Duration: ONE-D is a single-day (10-hour) treatment, whereas SAINT (Stanford Accelerated Intelligent Neuromodulation Therapy) is typically a 5-day course.
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Targeting: SAINT uses personalized targeting via functional MRI (fMRI) to locate the exact stimulation site. ONE-D uses a validated, scalp-based heuristic target for the left posterior DLPFC, making the procedure more accessible and faster to set up.
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Response Onset: A key finding of the ONE-D study was a delayed therapeutic response, with symptom improvement steadily increasing and reaching a plateau between weeks 4 and 6 post-treatment. This contrasts with the SAINT protocol, which reported a much more rapid response, with remission achieved in an average of 2.6 days.
- SAINT is FDA-cleared as a system on Magnus Medical equipment. ONE-D uses an FDA-cleared TMS device, but the one-day schedule is not cleared, so it is given off-label.
3. What is "Neuroplastogen Enhancement," and is it unique to ONE-D?
The medication step is what sets ONE-D apart from other accelerated protocols. The published protocol adds a single pre-treatment dose of two medications, D-cycloserine (DCS) and lisdexamfetamine, about an hour before the first TMS session. Both are used off-label here. They are included to support neuroplasticity, the brain's ability to form new connections, which may increase the treatment's effect. Depending on your health history, our physician may use one or both. Conventional rTMS and SAINT typically do not include medication.
4. What does the research show so far?
The evidence is early. ONE-D was first described in a 2024 review of 32 patients' charts at two private clinics (Vaughn et al.), which tracked depression and anxiety scores for 12 weeks. An 8-patient review from a primary care office followed in 2025 (Nanos). Neither study had a control group or randomization, and no study has compared ONE-D head to head with multi-week rTMS.
The Clinical TMS Society's December 2025 statement says this evidence is preliminary and asks clinics to be clear about that. We agree, and our team will go over it with you at your consult.
5. Is the ONE-D protocol safe, and are the results long-lasting?
In the 2024 chart review of 32 patients, every patient completed all 20 sessions on schedule and no serious adverse events were reported. The most common side effects were brief scalp discomfort and headache during treatment or in the week after, which are common with any TMS. How long the benefit lasts is still an open question: the review followed patients for 12 weeks, and its authors note that randomized trials are needed. Our team will go over follow-up care with you.
6. Is ONE-D TMS covered by insurance?
Because the one-day schedule is not FDA-cleared, it is given off-label, and insurance plans generally don't cover it. We offer One-D as cash pay: $3,000 covers your fMRI scan and the treatment day.
Testimonial for fMRI-Guided TMS
“The Most Impressive Therapy I’ve Ever Tried”: Tim Ferriss On Transcranial Magnetic Stimulation
Patient Reviews
Jennifer H.
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"Cognitive FX gave our daughter her life back! ... Cognitive FX is incredible; I can not adequately put into words how much we believe in their recovery program. We love the staff, and diagnostic measures, the recovery program, and the post-care follow up. I honestly can not think of one negative thing to say. The therapists are so attentive, skilled, caring and fun. Dr. Fong and RN Kaydee Severs are so incredibly smart, thorough in their explanations and exceptionally compassionate."
Review Source:
https://g.co/kgs/B5hSJ8
Liesel G.
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"Everyone was super nice and encouraging. The therapies were tailored to my individual strengths, weaknesses, and needs. I have had significant improvement and my last FMRI came back looking significantly better than the first one. I feel like I am getting back to my old self after nearly 5 years of problems and pain. I'm so grateful to everyone at Cognitive FX who helped me on my journey!"
Review Source:
https://g.co/kgs/5SLZpJ
Will H.
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"This place saved the life of someone we love. I was so impressed with the level of professionalism and care that we received. This facility is a blessing and I wouldn't hesitate at all to work with this team."
Review Source:
https://g.co/kgs/Hz35Pp
Chidinma O.
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"Cognitive Fx is a great place to receive treatment for post-concussive syndrome. They definitely listen to all the symptoms you experience in an objective manner. Their exams provide great validation of the weird post-concussive symptoms that neurologist typically have a hard time diagnosing. Also, just after a few days of treatment, I began noticing improvements on my symptoms. I’m very thankful for Cognitive Fx and I look forward to their science and research being utilized more in the treatment of brain injuries and complications."
Review Source:
https://g.co/kgs/W15sui
Michelle F.
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"...EPIC treatment at Cognitive FX was a lifesaver. I was shocked at how much better I felt after my week there! The fog lifted and the fatigue finally began to let up. I could focus, read, and attend better. I felt like myself! When the fNCI scan scientifically backed up what I was feeling, I cried with joy! The entire team is great! Everyone was so caring and helpful! The value of brain function is well worth the cost. I would recommend anyone who is struggling with PCS to meet with Dr. Fong. It was worth every penny I paid and more! I continue to work the program for brain health given to me when I completed the treatment."
Review Source:
https://g.co/kgs/zBo59R
Constantin L.
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"Best decision of my life, great experience, absolutely the best staff in health care, learned more about my injury than I would’ve dreamed of and got to know people that have gone through the same hardship as me, very helpful! If you’ve been suffering with PCS, think no further!"
Review Source:
https://g.co/kgs/hYv6uo
Stacy B.
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"I found this clinic during an online search of my symptoms. These guys are the first people to have ever taken me seriously and are some of the kindest human beings I have ever met. The program is extremely intensive and while I have not recovered fully yet, I feel like I have hope for the first time in 5 years. They give you a customized program to follow when you go home and I hopeful that by following this I will continue to improve. If you are struggling with brain function issues, please give them a shot - they are expensive but truly the best of the best."
Review Source:
https://g.co/kgs/SwJYMW
Hannah N.
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"This therapy treatment program was a lot of work but after just my first 2 days I had already seen so many positive impacts in my health. My body started to begin functioning like it did before my concussion. Everyone was very helpful and patient with me. I also loved that all the treatments were catered to my physical needs everyday."
Review Source:
https://g.co/kgs/uLhW6G
Michelle B
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I cannot rate Cognitive FX highly enough! Their accelerated TMS treatment proved to be incredibly effective with clear results. The staff were approachable and friendly, happy to assist in any way possible, making sure my every comfort and need were being met. They were careful to collect all the fMRIs and other information they needed before starting treatment. The treatment itself took five, eight-hour days and I had a reliable schedule created for me, treatments intermittent with exercise, therapy, massage sessions, and time just to relax and take a break. Food was provided for lunches as well as snacks any time I wanted. The accelerated TMS, while not a comfortable treatment, was made better by the staff taking feedback and adjusting the machine accordingly and entertaining me through each ten minute session. This treatment and facility went above and beyond my expectations. Cognitive FX turned out to be the miracle I needed and it's my hope that more places like Cognitive FX will make this treatment accessible to anyone who needs it.
Review Source:
https://g.co/kgs/2onAArP
If you're in crisis or thinking about suicide, call or text 988 now. One-D is not an emergency treatment.
One-D is an off-label use of an FDA-cleared TMS device. The one-day schedule and the pre-treatment medications are not FDA-cleared or approved for depression.
Medically reviewed by Dr. Lynn Gaufin, MD, Director of Neurosurgery, on October 28, 2026.
DISCLAIMER: SAINT™ is a trademark of The Board of Trustees of the Leland Stanford Junior University (“Stanford”) and has exclusively licensed such mark to Magnus Medical. Cognitive FX is neither endorsed by Stanford nor utilizes Magnus Medical equipment nor claims to be offering the SAINT protocol as prescribed by Stanford University et. al. or Magnus Medical. We provide fMRI guided intermittent theta burst TMS with target locations determined by fMRI and our prescribing physician.