Deep transcranial magnetic stimulation (dTMS) – beyond depression

Abstract

Deep transcranial magnetic stimulation (dTMS) utilizes different H-coils to study and treat a variety of psychiatric and neurological conditions with identifiable brain targets. The availability of this technology is dramatically changing the practice of psychiatry and neurology as it provides a safe and effective way to treat even drug-resistant patients. However, up until now, no effort was made to summarize the different types of H-coils that are available, and the conditions for which they were tested. Areas covered: Here we assembled all peer reviewed publication that used one of the H-coils, together with illustrations of the effective field they generate within the brain. Currently, the technology has FDA clearance for depression and European clearance for additional disorders, and multi-center trials are exploring its safety and effectiveness for OCD, PTSD, bipolar depression and nicotine addiction. Expert commentary: Taken together with positive results in smaller scale experiments, dTMS coils represent a non-invasive way to manipulate pathological activity in different brain structures and circuits. Advances in stimulation and imaging methods can now lead to efficacious and logical treatments. This should reduce the stigma associated with mental disorders, and improve access to psychiatric treatment.

Clinical and electrophysiological outcomes of deep TMS over the medial prefrontal and anterior cingulate cortices in OCD patients

“…These brain regions can be stimulated directly using deep TMS with the H7-coil ( Fig. S1 and [37]). However, the most effective frequency of stimulation cannot be predicted.…”

Group-Level Analysis of Induced Electric Field in Deep Brain Regions by Different TMS Coils

“…These structures are located 4.5-6.5 cm from the scalp, and their stimulation can lead to antidepressant effects in deep brain stimulation (DBS) (Berton and Nestler 2006;Schlaepfer et al 2008). Deep TMS (dTMS) has been proposed as an alternative non-invasive procedure (Levkovitz et al 2009;Tendler et al 2016;Kedzior et al 2018) and has been approved by the US Food and Drug Administration (FDA) for treatment of obsessive compulsive disorder. To stimulate the target areas located in deep regions beneath the scalp, different coils have been proposed for realizing stimulation more efficiently than with the conventional figure-8 coil (Ueno et al 1988).…”

Can deep transcranial magnetic stimulation (DTMS) be used to treat substance use disorders (SUD)? A systematic review

“…The current focus in the field is to test other therapeutic applications of DTMS beyond MDD [ 7 , 8 ]. One such application involves the use of DTMS for treatment of substance use disorders (SUD).…”