An Update on Repetitive Transcranial Magnetic Stimulation for the Treatment of Major Depressive Disorder

Abstract

Repetitive transcranial magnetic stimulation (rTMS) has emerged as an evidenced‐based treatment for major depression that does not respond to standard first‐line therapies. The majority of data support the use of high‐frequency (10 Hz) treatment delivered to the left dorsolateral prefrontal cortex. Intermittent theta burst stimulation is a new emerging treatment that reduces the time required to deliver treatment and can increase capacity and access to this treatment. This review will comprehensively cover recent advancements in the field of rTMS for depression, including stimulation parameters and targets aimed at enhancing outcomes. In addition, efforts to use modern neuroscience tools to personalize this treatment and optimize outcomes will be reviewed.

Integrating TMS, EEG, and MRI as an Approach for Studying Brain Connectivity

“…In the past two decades, the combination of single-pulse TMS and EEG, that is, TMS-EEG, has been proposed as an ideal tool to investigate cortical excitability and effective connectivity in normal (Rogasch and Fitzgerald 2013; Siebner and others 2009; Thut and Pascual-Leone 2010) and pathological brains (e.g., Bagattini and others 2019; Darmani and Ziemann 2019; Massimini and others 2012; Ragazzoni and others 2017; Sarasso and others 2014; Trevizol and Blumberger 2019) (see Box 2). Using EEG to track the activity induced by TMS, which propagates directly or indirectly to anatomically and functionally connected regions (Bonato and others 2006; Ilmoniemi and others 1997; Rogasch and others 2013; Voineskos and others 2010), it is possible to investigate communication across networks at rest and during execution of cognitive tasks (Bortoletto and others 2015).…”

A Novel Microwave Treatment for Sleep Disorders and Classification of Sleep Stages Using Multi-Scale Entropy

“…Most people with sleep disorders are treated with drugs such as 5-hydroxytryptamine and acetylcholine, which could cause potential harm to the body over time and can have a rebound effect [ 6 ]. The effect of treatment is obvious initially, then, after a time, the drug gradually appears to "fail" [ 7 ]. Many new forms of physical therapy, such as using sound, light, electricity, and magnetism to act on certain parts of the body [ 6 , 7 , 8 , 9 ], have been used to induce sleep.…”

“…The effect of treatment is obvious initially, then, after a time, the drug gradually appears to "fail" [ 7 ]. Many new forms of physical therapy, such as using sound, light, electricity, and magnetism to act on certain parts of the body [ 6 , 7 , 8 , 9 ], have been used to induce sleep. Electricity and magnetism can also stimulate neurons in the functional areas of the brain; a special frequency of weak electricity and weak magnetic field causes the resonance phenomena to affect the discharge frequency of brain functional areas, which, in turn, induces sleep [ 10 ].…”

A Physiological Marriage Made in Heaven: Treating and Measuring the Brain Through Stimulation

“…Repetitive transcranial magnetic stimulation has also been shown to be effective in a variety of additional disorders, including Parkinson's disease, which is a progressive neurologic disorder. In this issue, Fitzgerald provides a practice article focused on maintenance rTMS for depression, and Trevizol and Blumberger and Chen and Chen provide comprehensive reviews on the use of rTMS in the treatment of depression and Parkinson's disease, respectively; both articles highlight important potential areas of innovation to existing treatments that may galvanize further research aimed at improving approaches to rTMS treatment delivery.…”