Psychiatria pre prax 3/2013

Current status of repetitive transcranial magnetic stimulation in depression treatment

Research into the use of repetitive transcranial magnetic stimulation (rTMS) for the treatment of patients with depression has been conducted now for a period of greater than 18 years and a considerable body of knowledge has accumulated informing its use. Such experience with rTMS has optimized the parameters of stimulation, resulting in improved clinical effects of this technique. Techniques and protocols for individually targeting and dosing rTMS urgently need to be developed further in order to ascertain the accuracy, repeatability and reproducibility required of TMS in clinical applications. Optimal localization and orientation of stimuli with respect to the targeted anatomical structure and maintaining the stimuli location in repeated stimulations eliminates the root causes of variability due to physical factors. Keeping the above-mentioned important caveats in mind, navigation solves many of the critical measurement issues associated with TMS. Another strategy for improving rTMS efficacy may be to explore alternatives to the conventional stimulation target in the dorsolateral prefrontal cortex.

Keywords: repetitive transcranial magnetic stimulation, rTMS, stimulations, depression, neuronavigation, prefrontal cortex.