Transcranial magnetic stimulation as a therapeutic tool in psychiatry

Abstract

Transcranial magnetic stimulation (TMS) is a patient-friendly stimulation technique of the brain with interesting perspectives. In clinical psychiatry, limited data are available on activity in psychosis and anxiety, but much research has been done in depression. Major concerns on published papers are the inconsistency of used parameter settings, the restraint numbers of patients in randomised trials, the lack of real sham controlled studies and the quasi inexistent reproducibility of results. The most stringent meta-analysis of TMS in affective disorders found a modest, statistically significant antidepressant effect after 2 weeks of daily treatment of high frequency repetitive left dorsolateral prefrontal cortex stimulation. Although most results are rather weak and not convincing enough to promote TMS as evidence-based antidepressive therapy, they show a measurable action that should not be ignored. Preclinical and clinical effects were observed analysing heterogeneous data, and results comparing TMS to electroconvulsive therapy (ECT) in affective disorders are encouraging. Efforts should continue with emphasis on increasing homogeneity and reproducibility in data. Further refinement of stimulation parameters should be established, so that new and large double-blind, long-term, sham-controlled trials can bring us to better understanding and standardising TMS procedure, finally leading to definitive conclusions about its efficacy in psychiatry.

No influence of one right-sided prefrontal HF-rTMS session on alcohol craving in recently detoxified alcohol-dependent patients: Results of a naturalistic study

“…Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive technique with a treatment potential for a variety of neuropsychiatric illnesses (George et al, 2002;Simons and Dierick, 2005). Research has revealed the potential anti-craving effects of rTMS in substance dependence such as nicotine, cocaine and alcohol dependence (Barr et al, 2008, De Ridder et al, 2011.…”

HF-rTMS Treatment in Medication-Resistant Melancholic Depression:Results from18FDG-PET Brain Imaging

“…1,2 Currently, the physiological influence and treatment effects of repetitive TMS (rTMS) are under investigation. [3][4][5] As a focused cortical intervention, the majority of all treatment studies in depression target the dorsolateral prefrontal cortex (DLPFC) as the area of interest for rTMS. 6,7 However, it remains unclear which TMS parameters can produce the most benefits.…”

Repetitive Transcranial Magnetic Stimulation to Treat Depression and Insomnia with Chronic Low Back Pain

“…TMS produces brief magnetic pulses, which pass easily and painlessly through the skull and into the brain. TMS is commonly used to treat neurological and psychiatric disorders including mood disorders, dystonia, and Parkinson's disease [4]. TMS has been used for pain relief in chronic pain syndromes such as fibromyalgia, complex regional pain syndrome, and other neuropathic pain conditions [5].…”