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Acute rTMS Treatment for Depression

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Repetitive Transcranial Magnetic Stimulation Treatment for Depressive Disorders

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Abstract

A substantive series of clinical trials have supported the antidepressant efficacy of high-frequency rTMS applied to the left dorsolateral prefrontal cortex. The results of these trials have been summarised in several meta-analyses which support the positive antidepressant efficacy of this technique. Studies comparing rTMS and ECT have been substantially limited by sample size and design issues. In addition to high-frequency rTMS, studies have explored the use of low-frequency rTMS applied to the right dorsolateral prefrontal cortex. The studies have also consistently found significant antidepressant effects. Studies which have explored the use of sequential bilateral rTMS combining both high- and low-frequency approaches have been inconsistent with recent data suggesting that this technique is not more effective than unilateral stimulation. Studies are continuing to explore the use of novel stimulation parameters such as priming and theta burst TMS. There are a number of significant methodological issues that need to be considered in evaluating rTMS trials and the application of this treatment. These include the method of coil localisation and the way in which sham treatment is applied in clinical trials.

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Authors and Affiliations

  1. Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School and The Alfred, Melbourne, Victoria, Australia

    Paul B. Fitzgerald (Professor of Psychiatry)

  2. Centre for Addiction and Mental Health (CAMH), University of Toronto, Toronto, Ontario, Canada

    Z. Jeff Daskalakis

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Fitzgerald, P.B., Daskalakis, Z.J. (2013). Acute rTMS Treatment for Depression. In: Repetitive Transcranial Magnetic Stimulation Treatment for Depressive Disorders. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-36467-9_4

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  • DOI: https://doi.org/10.1007/978-3-642-36467-9_4

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