Consensus review and considerations on TMS to treat depression: A comprehensive update endorsed by the National Network of Depression Centers, the Clinical TMS Society, and the International Federation of Clinical Neurophysiology

Nicholas T Trapp¹, Anthony Purgianto², Joseph J Taylor³, Manpreet K Singh⁴, Lindsay M Oberman⁵, Brian J Mickey⁶, Nagy A Youssef⁷, Daniela Solzbacher⁶, Benjamin Zebley⁸, Laura Y Cabrera⁹, Susan Conroy¹⁰, Mario Cristancho¹¹, Jackson R Richards², Michael J Flood¹², Tracy Barbour¹³, Daniel M Blumberger¹⁴, Stephan F Taylor¹⁵, David Feifel¹⁶, Irving M Reti¹⁷, Shawn M McClintock¹⁸, Sarah H Lisanby¹⁹, Mustafa M Husain²⁰; National Network of Depression Centers Neuromodulation Task Group

Affiliations

¹ Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA; Iowa Neuroscience Institute, University of Iowa, Iowa City, IA, USA. Electronic address: nicholas-trapp@uiowa.edu.
² Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
³ Center for Brain Circuit Therapeutics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
⁴ Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, USA.
⁵ Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA.
⁶ Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, UT, USA.
⁷ Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA; Division of Psychiatry and Behavioral Medicine, Michigan State University, Grand Rapids, MI, USA.
⁸ Department of Psychiatry, Weill Cornell Medicine, NewYork-Presbyterian Hospital, New York, NY, USA.
⁹ Department of Engineering Science and Mechanics, Center for Neural Engineering, Pennsylvania State University, University Park, PA, USA.
¹⁰ Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA.
¹¹ Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
¹² National Network of Depression Centers, Ann Arbor, MI, USA.
¹³ Division of Neuropsychiatry and Neuromodulation, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
¹⁴ Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada.
¹⁵ Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
¹⁶ Kadima Neuropsychiatry Institute, La Jolla, CA, USA; University of California-San Diego, San Diego, CA, USA.
¹⁷ Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA.
¹⁸ Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas,TX, USA.
¹⁹ Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA; Division of Translational Research, National Institute of Mental Health, Bethesda, MD, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
²⁰ Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas,TX, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.

PMID: 39756350
PMCID: PMC11825283 (available on 2026-02-01)
DOI: 10.1016/j.clinph.2024.12.015

Review

Consensus review and considerations on TMS to treat depression: A comprehensive update endorsed by the National Network of Depression Centers, the Clinical TMS Society, and the International Federation of Clinical Neurophysiology

Nicholas T Trapp et al. Clin Neurophysiol. 2025 Feb.

. 2025 Feb:170:206-233.

doi: 10.1016/j.clinph.2024.12.015. Epub 2024 Dec 19.

Authors

Affiliations

¹ Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA; Iowa Neuroscience Institute, University of Iowa, Iowa City, IA, USA. Electronic address: nicholas-trapp@uiowa.edu.
² Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
³ Center for Brain Circuit Therapeutics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
⁴ Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, USA.
⁵ Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA.
⁶ Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, UT, USA.
⁷ Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA; Division of Psychiatry and Behavioral Medicine, Michigan State University, Grand Rapids, MI, USA.
⁸ Department of Psychiatry, Weill Cornell Medicine, NewYork-Presbyterian Hospital, New York, NY, USA.
⁹ Department of Engineering Science and Mechanics, Center for Neural Engineering, Pennsylvania State University, University Park, PA, USA.
¹⁰ Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA.
¹¹ Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
¹² National Network of Depression Centers, Ann Arbor, MI, USA.
¹³ Division of Neuropsychiatry and Neuromodulation, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
¹⁴ Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada.
¹⁵ Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
¹⁶ Kadima Neuropsychiatry Institute, La Jolla, CA, USA; University of California-San Diego, San Diego, CA, USA.
¹⁷ Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA.
¹⁸ Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas,TX, USA.
¹⁹ Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA; Division of Translational Research, National Institute of Mental Health, Bethesda, MD, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
²⁰ Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas,TX, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.

PMID: 39756350
PMCID: PMC11825283 (available on 2026-02-01)
DOI: 10.1016/j.clinph.2024.12.015

Abstract

This article updates the prior 2018 consensus statement by the National Network of Depression Centers (NNDC) on the use of transcranial magnetic stimulation (TMS) in the treatment of depression, incorporating recent research and clinical developments. Publications on TMS and depression between September 2016 and April 2024 were identified using methods informed by PRISMA guidelines. The NNDC Neuromodulation Work Group met monthly between October 2022 and April 2024 to define important clinical topics and review pertinent literature. A modified Delphi method was used to achieve consensus. 2,396 abstracts and manuscripts met inclusion criteria for review. The work group generated consensus statements which include an updated narrative review of TMS safety, efficacy, and clinical features of use for depression. Considerations related to training, roles/responsibilities of providers, and documentation are also discussed. TMS continues to demonstrate broad evidence for safety and efficacy in treating depression. Newer forms of TMS are faster and potentially more effective than conventional repetitive TMS. Further exploration of targeting methods, use in special populations, and accelerated protocols is encouraged. This article provides an updated overview of topics relevant to the administration of TMS for depression and summarizes expert, consensus opinion on the practice of TMS in the United States.

Keywords: Consensus; Depression; Depressive disorders; Theta burst stimulation; Transcranial magnetic stimulation.

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Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

References

1. Aaronson ST, Carpenter LL, Hutton TM, Kraus S, Mina M, Pages K, et al. Comparison of clinical outcomes with left unilateral and sequential bilateral Transcranial Magnetic Stimulation (TMS) treatment of major depressive disorder in a large patient registry. Brain Stimul 2022;15(2):326–36. - PubMed
1. Ahdab R, Ayache SS, Brugieres P, Goujon C, Lefaucheur JP. Comparison of “standard” and “navigated” procedures of TMS coil positioning over motor, premotor and prefrontal targets in patients with chronic pain and depression. Neurophysiologie clinique = Clinical neurophysiology 2010;40(1):27–36. - PubMed
1. Allen CH, Kluger BM, Buard I. Safety of Transcranial Magnetic Stimulation in Children: A Systematic Review of the Literature. Pediatr Neurol 2017;68:3–17. - PMC - PubMed
1. Avery DH, Isenberg KE, Sampson SM, Janicak PG, Lisanby SH, Maixner DF, et al. Transcranial magnetic stimulation in the acute treatment of major depressive disorder: clinical response in an open-label extension trial. J Clin Psychiatry 2008;69(3):441–51. - PubMed
1. Beam W, Borckardt JJ, Reeves ST, George MS. An efficient and accurate new method for locating the F3 position for prefrontal TMS applications. Brain Stimul 2009;2(1):50–4. - PMC - PubMed

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Consensus review and considerations on TMS to treat depression: A comprehensive update endorsed by the National Network of Depression Centers, the Clinical TMS Society, and the International Federation of Clinical Neurophysiology

Affiliations

Consensus review and considerations on TMS to treat depression: A comprehensive update endorsed by the National Network of Depression Centers, the Clinical TMS Society, and the International Federation of Clinical Neurophysiology

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous