Transcranial Magnetic Stimulation: A Novel Antidepressive Strategy?

Conca, Andreas; Koppi, St.; König, Peter; Swoboda, E.; Krecké, N.

doi:10.1159/000119312

Cited by 93 publications

(59 citation statements)

References 10 publications

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“…Several early case reports (14) and reports of single pulses or very slow trains of TMS applied to multiple sites (15)(16)(17) or at the vertex (18) produced encouraging initial results. In the wake of these studies, more rigorous studies were performed in which sequences of repetitive transcranial magnetic stimulation (rTMS) were applied to one brain region.…”

Section: Clinical Resultsmentioning

confidence: 98%

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Transcranial Magnetic Stimulation in the Treatment of Depression

Gershon

Dannon²,

Grunhaus³

2003

AJP

459

246

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Objective: Transcranial magnetic stimulation (TMS) is a noninvasive and easily tolerated method of altering cortical physiology. The authors evaluate evidence from the last decade supporting a possible role for TMS in the treatment of depression and explore clinical and technical considerations that might bear on treatment success. Method:The authors review English-language controlled studies of nonconvulsive TMS therapy for depression that appeared in the MEDLINE database through early 2002, as well as one study that was in press in 2002 and was published in 2003. In addition, the authors discuss studies that have examined technical, methodological, and clinical treatment parameters of TMS. Results:Most data support an antidepressant effect of high-frequency repetitive TMS administered to the left prefrontal cortex. The absence of psychosis, younger age, and certain brain physiologic markers might predict treatment success. Technical parameters possibly affecting treatment success include intensity and duration of treatment, but these suggestions require systematic testing.Conclusions: TMS shows promise as a novel antidepressant treatment. Systematic and large-scale studies are needed to identify patient populations most likely to benefit and treatment parameters most likely to produce success. In addition to its potential clinical role, TMS promises to provide insights into the pathophysiology of depression through research designs in which the ability of TMS to alter brain activity is coupled with functional neuroimaging. (Am J Psychiatry 2003; 160:835-845)In 1831, Michael Faraday discovered that electrical currents can be converted into magnetic fields and vice versa. His principle of mutual induction is the basis of transcranial magnetic stimulation (TMS). In TMS, a bank of capacitors is rapidly discharged into an electric coil to produce a magnetic field pulse (Figure 1). When the coil is placed near the head of a human or animal, the magnetic field penetrates the brain and induces an electric field in the underlying region of the cerebral cortex (4) (Figure 2). An electrical field of sufficient intensity will depolarize cortical neurons, generating action potentials. These then propagate to exert their biological effects. For example, TMS over the left motor cortex causes action potentials that propagate through the corticospinal tract, causing twitches in contralateral skeletal muscles.This new technology has been used to affect underlying brain tissue at several levels. First, TMS can alter regional activity within the cortex. Positron emission tomography (PET) has revealed changes in cortical metabolism and dose-dependent changes in regional cortical blood flow in response to TMS (5-7). Such changes are also observed at sites distant from the magnetic stimulus, showing that the effects of TMS propagate to other parts of the brain (6, 7). The connections demonstrated in this manner correspond to known neural pathways in nonhuman primates, suggesting that the propagation of TMS effects occurs by means of...

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Section: Clinical Resultsmentioning

confidence: 98%

“…Although different studies have used various frequencies, two overall types have been used: low frequency (≤1 Hz) and high frequency (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). This distinction is important because the two types of stimulation have opposite effects on brain physiology.…”

Section: Pulse Frequency-slow Versus Fast Rtmsmentioning

confidence: 99%

Transcranial Magnetic Stimulation in the Treatment of Depression

Gershon

Dannon²,

Grunhaus³

2003

AJP

459

246

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“…Moreover, the effect of rTMS is not limited to the targeted brain region as changes can also occur at distant interconnected sites of the brain. That is, the application of rTMS over cortical brain regions may provide a possible mechanism through which to infl uence subcortical regions that regulate emotion and behaviour (Ben-Shachar et al, 1997;Burt et al, 2002;Conca et al, 1996;Gershon et al, 2003;A. Post & Keck, 2001).…”

Section: Introductionmentioning

confidence: 99%

Repetitive transcranial magnetic stimulation and drug addiction

Barr

Farzan

Wing

et al. 2011

International Review of Psychiatry

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Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation technique that is now being tested for its ability to treat addiction. This review discusses current research approaches and results of studies which measured the therapeutic use of rTMS to treat tobacco, alcohol and illicit drug addiction. The research in this area is limited and therefore all studies evaluating the therapeutic use of rTMS in tobacco, alcohol or illicit drug addiction were retained including case studies through NCBI PubMed (http://www.ncbi.nlm.nih.gov) and manual searches. A total of eight studies were identifi ed that examined the ability of rTMS to treat tobacco, alcohol and cocaine addiction. The results of this review indicate that rTMS is effective in reducing the level of cravings for smoking, alcohol, and cocaine when applied at high frequencies to the dorsolateral prefrontal cortex (DLPFC). Furthermore, these studies suggest that repeated sessions of high frequency rTMS over the DLPFC may be most effective in reducing the level of smoking and alcohol consumption. Although work in this area is limited, this review indicates that rTMS is a promising modality for treating drug addiction.

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“…With these caveats in mind, it is of interest to look at the effect sizes of the published trials that involved more than 15 patients with depression (see Table 1). Among the open trials are those of Conca et al (1996), Figiel et al (1998) and Grunhaus et al (1998). Conca et al (1996) used single pulse stimulation (0.17 Hz) over multiple sites in a randomised subgroup of six out of 12 patients with depression on medication.…”

Section: Therapeutic Use In Affective Disordersmentioning

confidence: 99%

Electromagnetic stimulation in psychiatry

Ebmeier¹,

Lappin²

2001

Adv. psychiatr. treat

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One hundred years ago, D'Arsonval and Beer first described the effects of magnetic fields on human brain function. Placing one's head into a powerful magnet produced phosphenes, vertigo or even syncopes (George & Belmaker, 2000). However, only since 1985 has the technology of fast discharging capacitors developed sufficiently to generate reproducible effects across the intact skull, with peak magnetic field strengths of about 1–2 tesla (Barker et al, 1985). The headline-grabbing news has been about therapeutic applications of transcranial magnetic stimulation (TMS), but in the meantime a revolution in functional brain research has taken place, based on the manipulation of brain activity by focused magnetic fields. TMS applied in this way is, in a manner of speaking, brain imaging in the reverse. While common modes of functional brain imaging, such as positron emission tomography (PET) and functional magnetic resonance imaging (fMRI), demonstrate associations between brain metabolic activity and ‘brain tasks', the causal interpretation of such associations can be difficult. Is the frontal lobe activation observed during a memory task, for example, necessary for performing the task, or does it correspond to monitoring activity that runs parallel to task performance proper? If, on the other hand, focal brain activation during TMS results in a muscle twitch, there is no doubt that stimulation of at least some of the neurons within the magnetic field is sufficient cause for the observed movement. Functional neuroimaging is now often combined with TMS, carried out in the same session in order to exploit the complementary strengths of the methods. Although direct stimulation of association (as opposed to motor or sensory) cortex does not usually result in an observable response, TMS applied in repetitive trains can produce reversible ‘lesions'. By interfering with tasks that are dependent on the functioning of the stimulated neurons, it can thus contribute to the localisation of brain function.

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Transcranial Magnetic Stimulation: A Novel Antidepressive Strategy?

Cited by 93 publications

References 10 publications

Transcranial Magnetic Stimulation in the Treatment of Depression

Transcranial Magnetic Stimulation in the Treatment of Depression

Repetitive transcranial magnetic stimulation and drug addiction

Electromagnetic stimulation in psychiatry

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