Repetitive transcranial magnetic stimulation as a neuropsychiatric tool: present status and future potential
by
Post RM, Kimbrell TA, McCann UD,
Dunn RT, Osuch EA, Speer AM, Weiss SR
Biological Psychiatry Branch,
National Institute of Mental Health,
National Institutes of Health, Bethesda, Maryland, USA.
J ECT 1999 Mar; 15(1):39-59

ABSTRACT

Repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising therapeutic intervention in the treatment of affective disorders. The differences in the type of electrical stimulation required for therapeutic efficacy by rTMS and electroconvulsive therapy (ECT) are discussed. In contrast to ECT, rTMS would not appear to require the generation of a major motor seizure to achieve therapeutic efficacy. Accordingly, it carries the potentially important clinical advantages of not requiring anesthesia and of avoiding side effects such as transient memory loss. Preclinical studies on long-term potentiation (LTP) and long-term depression (LTD) in hippocampal and amygdala slices, as well as clinical data from neuroimaging studies, have provided encouraging clues for potential frequency-dependent effects of rTMS. Preliminary evidence from position emission tomography (PET) scans suggests that higher frequency (20 Hz) stimulation may increase brain glucose metabolism in a transsynaptic fashion, whereas lower frequency (1 Hz) stimulation may decrease it. Therefore, the ability of rTMS to control the frequency as well as the location of stimulation, in addition to its other advantages, has opened up new possibilities for clinical explorations and treatments of neuropsychiatric conditions.

rTMS
TCAs
SSRIs
RIMAs
Bupropion
Amineptine
Reboxetine
Nefazodone
Mirtazapine
Venlafaxine
rTMS versus ECT
Vagus nerve stimulation
ECT versus rTMS for severe depression
Repetitive transcranial magnetic stimulation
High-frequency repetitive transcranial magnetic stimulation
Repetitive transcranial magnetic stimulation (RTMS) to treat refractory depression

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