Abstract

Repetitive transcranial magnetic stimulation for treatment-resistant depression

Author(s): Adam Philip Stern,Daniel Cohen

Repetitive transcranial magnetic stimulation (rTMS) is a treatment option for patients with treatment-resistant depression. By noninvasively targeting excitability in specific functional neuronal circuits, rTMS treatment represents an increasingly accessible approach toward affecting brain functioning with limited adverse effects. By making use of targeted applications of Ampere’s and Farraday’s laws of physics, rTMS is thought to affect neuronal circuitry in multiple ways, including affecting cerebral blood flow, cortical excitability, neuroendocrine functioning and hemispheric balance. While the noninvasive use of this technology can potentially be applied to any number of brain areas for exploration or modulation, its utility and effectiveness is best demonstrated thus far in the treatment of treatment-resistant depression. The future use of this treatment option will depend upon further technological and logistical advances that can help to clarify effective use, cost–effectiveness, access to treatment and patient selection.