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Review
. 2019 Sep;32(5):409-415.
doi: 10.1097/YCO.0000000000000533.

Repetitive transcranial magnetic stimulation treatment for depressive disorders: current knowledge and future directions

Chris Baeken  1   2   3 , Anna-Katharine Brem  4   5 , Martijn Arns  6   7 , Andre R Brunoni  8 , Igor Filipčić  9   10 , Ana Ganho-Ávila  11 , Berthold Langguth  12 , Frank Padberg  13 , Emmanuel Poulet  14 , Fady Rachid  15 , Alexander T Sack  16 , Marie-Anne Vanderhasselt  17 , Djamila Bennabi  18
Affiliations
Review

Repetitive transcranial magnetic stimulation treatment for depressive disorders: current knowledge and future directions

Chris Baeken et al. Curr Opin Psychiatry. 2019 Sep.

Abstract

Purpose of review: After three decades of clinical research on repetitive transcranial magnetic stimulation (rTMS), major depressive disorder (MDD) has proven to be the primary field of application. MDD poses a major challenge for health systems worldwide, emphasizing the need for improving clinical efficacy of existing rTMS applications and promoting the development of novel evidence-based rTMS treatment approaches.

Recent findings: Several promising new avenues have been proposed: novel stimulation patterns, targets, and coils; combinatory treatments and maintenance; and personalization and stratification of rTMS parameters, and treatment of subpopulations.

Summary: This opinion review summarizes current knowledge in the field and addresses the future direction of rTMS treatment in MDD, facilitating the establishment of this clinical intervention method as a standard treatment option and continuing to improve response and remission rates, and take the necessary steps to personalize rTMS-based treatment approaches.

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Figures

FIGURE 1
FIGURE 1
Response and remission rates of various monotherapeutic and combinatory antidepressant treatments based on the largest studies and datasets available. psychotherapy monotherapy, psychotherapy and antidepressants, antidepressants as first line, after one, two, and three treatment failures from the STAR∗D trial, rTMS monotherapy, and rTMS combined with psychotherapy. Note the relative increase in response and remission rates for rTMS, especially relative to patients that have had two or three prior treatment failures (i.e. treatment-resistant depression), which is the typical population rTMS treatment is currently indicated for. MDD, major depressive disorder; rTMS, repetitive transcranial magnetic stimulation. Source: Adapted with permission from Refs. [–30,49].
Box 1
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