Clinical Efficacy of Repetitive Transcranial Magnetic Stimulation for Treatment of Depression and Latest Trends in TMS Techniques

반복 경두개자기자극술의 우울증 치료효과 및 최신동향에 대한 고찰

  • Kim, Shin Tae (Yonsei University College of Medicine) ;
  • Kim, Hae Won (Department of Psychiatry, Yonsei University College of Medicine) ;
  • Kim, Se Joo (Department of Psychiatry, Yonsei University College of Medicine) ;
  • Kang, Jee In (Department of Psychiatry, Yonsei University College of Medicine)
  • 김신태 (연세대학교 의과대학) ;
  • 김혜원 (연세대학교 의과대학 정신건강의학교실) ;
  • 김세주 (연세대학교 의과대학 정신건강의학교실) ;
  • 강지인 (연세대학교 의과대학 정신건강의학교실)
  • Received : 2017.06.01
  • Accepted : 2017.06.15
  • Published : 2017.08.31

Abstract

Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation technique which can change cortical excitability in targeted area by producing magnetic field pulses with an electromagnetic coil. rTMS treatment has been used to treat various neuropsychiatric disorders including depression. In this review, we evaluate the literature on rTMS for depression by assessing its efficacy on different subtypes of depression and different technical parameters. In particular, we focus on the results of randomized clinical trials and meta-analyses for depression after the US Food and Drug Administration approval in 2008, which acknowledged its efficacy and acceptability. We also review the new forms of rTMS therapy including deep TMS, theta-burst stimulation, and magnetic seizure therapy (MST) that have been under recent investigation. High frequency rTMS over left dorsolateral prefrontal cortex (DLPFC), low frequency rTMS over right DLPFC, or bilateral rTMS is shown to be effective and acceptable in treatment for patients with non-psychotic, unipolar depression either as monotherapy or adjuvant. Deep TMS, theta-burst stimulation and MST are promising new TMS techniques which warrant further research.

Acknowledgement

Supported by : Korea Health Industry Development Institute (KHIDI)

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