Does SAINT® TMS Require an MRI? Yes. Here's Why the Scan Matters
Yes. Every SAINT® patient has a brain MRI before treatment. Software uses the scan's functional-connectivity data to pick the exact spot to stimulate for that person. A clinic that offers a 5-day course without a brain scan isn't delivering SAINT®.
Key takeaways
- Yes. SAINT® requires a structural MRI and a functional MRI (fMRI) before treatment.
- The scan maps brain connectivity to compute a personalized stimulation target.
- A 5-day accelerated course delivered without a brain MRI is not SAINT®.
- The scan is painless, non-invasive, and requires no contrast injection.
- People with non-removable magnetic-sensitive metal in the head or certain implants cannot have the MRI.
Does SAINT TMS require an MRI?
Yes. Every SAINT® patient has a brain MRI before treatment. Software uses the scan's functional-connectivity data to pick the exact spot to stimulate for that person. A clinic that offers a 5-day course without a brain scan isn't delivering SAINT®.
Conventional TMS places the coil using a scalp measurement — the distance from the spot that makes the thumb twitch. SAINT® replaces this ruler-based approach with a functional MRI that maps how each patient's brain is wired. The software identifies the specific location on the left dorsolateral prefrontal cortex that has the strongest functional connection to the subgenual anterior cingulate cortex, a deeper region involved in mood regulation.
Can SAINT be done without an fMRI?
No. Personalized MRI targeting is part of the FDA-cleared protocol. Without the scan, software cannot compute the individualized target, and the treatment cannot be SAINT®.
Some clinics offer 5-day accelerated TMS programs that copy the 50-session schedule but skip the MRI scan, using scalp or head measurements instead. While these off-label programs exist, they are a different treatment and cannot claim the FDA clearance or trial results of SAINT®.
Is head-measurement targeting the same as SAINT targeting?
No. Head-measurement methods — such as measuring from the motor cortex or using scalp-based coordinates like the BEAM F3 method — rely on population averages and external landmarks.
SAINT® targeting uses your actual functional MRI scan to locate your unique brain circuit. Because human brain anatomy and functional connectivity vary significantly between individuals, a scalp measurement cannot identify your specific subgenual-connected target. Learn more about fMRI-guided TMS vs scalp targeting.
What happens during the SAINT MRI?
The scan is painless, non-invasive, and uses no contrast dye or injections. You simply lie still in the MRI scanner for roughly 45 to 60 minutes while the structural and resting-state functional MRI images are gathered.
The scan is a one-time requirement completed before your treatment week begins. It is not repeated during the five days of treatment. Once the algorithm processes your scan and computes your target, that exact coordinate is used for all 50 sessions during your week.
Who can't have the MRI?
Standard MRI safety screening applies before scheduling. People with non-removable ferromagnetic metal in or near the head — such as cochlear implants, aneurysm clips, or certain stents — or implanted electronic stimulators cannot safely have an MRI.
Because the brain MRI is an essential requirement of the SAINT® protocol, individuals who cannot safely undergo an MRI are not candidates for SAINT®. Conventional TMS, which does not require an MRI, may still be an option.
Understanding SAINT® TMS: How It Works & What to Expect
SAINT® is an FDA-cleared treatment for adults with major depressive disorder who have not improved on antidepressants in the current episode. These videos explain how it works and how it differs from conventional TMS.
SAINT® is an FDA-cleared, fMRI-guided form of TMS developed at Stanford. Most patients complete treatment in one week — not the six weeks standard TMS requires.
Follow a real patient through the five-day SAINT® treatment week
Is SAINT® TMS Right for You?
Tried antidepressants without enough relief? SAINT® TMS is an FDA-cleared, fMRI-guided treatment for adults with major depressive disorder who have not improved enough with antidepressant medication.
SAINT® uses a personalized brain target and delivers treatment over five consecutive days. It differs from standard TMS in its targeting approach, treatment schedule, and research background. In a small randomized trial, 11 of 14 people receiving active treatment reached remission at the four-week assessment, compared with 2 of 15 receiving sham treatment. Results vary, and a five-day treatment course does not guarantee remission in five days.
How SAINT® Works and How It Differs From Conventional TMS
SAINT® is an FDA-cleared treatment for adults with major depressive disorder who have not improved on antidepressants in the current episode. This video explains how it works, and how it differs from conventional TMS.
Conventional TMS usually means about 30 visits over 6 to 9 weeks. SAINT is five visits over five days.
What makes it different: SAINT is the only FDA-cleared depression treatment that uses an fMRI scan to personalize the stimulation target to your individual brain. A 45-minute scan maps your brain and identifies the specific circuit linked to depression. Treatment is then delivered as ten 10-minute sessions per day, with 50-minute breaks between them, across five consecutive days.
In clinical trials, 79% of participants reached remission, with an average of 2.6 days to remission. SAINT is generally well tolerated; the most common side effects reported were mild headache and temporary scalp discomfort at the treatment site.
SAINT® at Neuro Wellness TMS Centers of America
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Sources: Cole et al., American Journal of Psychiatry 2020;177:716-726 and 2022;179(2):132-141. magnusmedical.com/depression-therapy. PubMed 34711062. FDA 510(k) K220177.
Insurance coverage for SAINT is currently limited and varies by plan. Individual results may vary. This video is educational and is not medical advice. Talk to a qualified clinician about whether SAINT is appropriate for you. If you are in crisis, call or text 988.
Frequently Asked Questions
Does SAINT TMS require an MRI?
Yes. Every SAINT® patient has a brain MRI before treatment. Software uses the scan's functional-connectivity data to pick the exact spot to stimulate for that person. A clinic that offers a 5-day course without a brain scan isn't delivering SAINT®.
Can SAINT be done without an fMRI?
No. Personalized MRI targeting is part of the FDA-cleared protocol. Without the fMRI scan, software cannot compute the individualized target, and the treatment is not SAINT®.
Is head-measurement targeting the same as SAINT targeting?
No. Head-measurement methods rely on scalp landmarks and population averages. SAINT® uses a functional MRI to map your individual brain circuitry.
What happens during the SAINT MRI?
The MRI is painless, non-invasive, and requires no contrast injection. You lie still in the scanner for about 45 to 60 minutes before your treatment week. The scan is a one-time requirement.
Who can't have the MRI?
People with non-removable magnetic-sensitive metal in or near the head, cochlear implants, aneurysm clips, or implanted electronic devices cannot safely have an MRI and are not candidates for SAINT®.
Cited Research
SAINT® is delivered only by verified providers on the Magnus Medical system. Programs described as SAINT “alternatives”, “equivalents” or “fMRI-guided accelerated TMS” are not SAINT®, are not affiliated with us, and SAINT® results do not apply to them. Read our SAINT® disclaimer.
Have questions about whether TMS may be appropriate for you?
Speak with our clinical team. A free consultation is the best way to get answers specific to your situation.
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What Is SAINT® TMS?
FDA clearance, protocol, and evidence
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What Happens During SAINT®
Day-by-day guide to the five-day protocol
SAINT® vs Traditional TMS
How SAINT compares to standard TMS
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