Skip to main content
×
×
Home

Transcranial magnetic stimulation in clinical practice

  • Sheila Hardy, Lorraine Bastick, Alex O'Neill-Kerr, Priyadharshini Sabesan, Sudheer Lankappa and Lena Palaniyappan...
Summary

Up to 40% of people with depression do not recover following standard treatments such as medication and psychotherapy. Transcranial magnetic stimulation (TMS) is a treatment used worldwide for adult patients with severe clinical depression when antidepressants have repeatedly failed to control their symptoms. This article explains the use of TMS in clinical practice.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Transcranial magnetic stimulation in clinical practice
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Transcranial magnetic stimulation in clinical practice
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Transcranial magnetic stimulation in clinical practice
      Available formats
      ×
Copyright
Corresponding author
Dr Sheila Hardy, Northamptonshire Healthcare NHS Foundation Trust, Berrywood Hospital, Berrywood Drive, Northampton NN5 6UD, UK. Email: sheila.hardy@nhft.nhs.uk
Footnotes
Hide All

LEARNING OBJECTIVES

• Understand how TMS works in the treatment of depression

• Appreciate which patients will beneft from TMS and when it is contraindicated

• Be aware of the current clinical guidance for the use of TMS as a treatment for depression

DECLARATION OF INTEREST

L.P. received travel support to speak at a meeting organised by Magstim (makers of a TMS device) at Oxford in 2014.

Footnotes
References
Hide All
Allan, C, Herrmann, L, Ebmeier, K (2011) Transcranial magnetic stimulation in the management of mood disorders. Neuropsychobiology, 64: 163–9.
American Psychiatric Association (2013) The Diagnostic and Statistical Manual of Mental Disorders (5th edn) (DSM-5). APA.
Barker, A, Jalinous, R, Freeson, I (1985) Non-invasive magnetic stimulation of the human motor cortex. Lancet, 1: 1106–7.
Bauer, M, Whybrow, PC, Angst, J et al (2002) World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Unipolar Depressive Disorders, Part 1: Acute and continuation treatment of major depressive disorder. World Journal of Biological Psychiatry, 3: 5-43.
Berlim, M, Van den Eynde, F, Daskalakis, Z (2013a) A systematic review and meta-analysis on the efficacy and acceptability of bilateral repetitive transcranial magnetic stimulation (rTMS) for treating major depression. Psychological Medicine, 43: 2245–54
Berlim, M, Van den Eynde, F, Daskalakis, Z (2013b) Efficacy and acceptability of high frequency repetitive transcranial magnetic stimulation (rTMS) versus electroconvulsive therapy (ECT) for major depression: a systematic review and meta-analysis of randomized trials. Depression and Anxiety, 30: 614–23.
Berlim, M, Van den Eynde, F, Daskalakis, ZJ (2013c) Clinically meaningful efficacy and acceptability of low-frequency repetitive transcranial magnetic stimulation (rTMS) for treating primary major depression: a meta-analysis of randomized, double-blind and sham-controlled trials. Neuropsychopharmacology, 38: 543–51.
Berlim, MT, Van den Eynde, F, Daskalakis, ZJ (2013d) High-frequency repetitive transcranial magnetic stimulation accelerates and enhances the clinical response to antidepressants in major depression: a meta-analysis of randomized, double-blind, and sham-controlled trials. Journal of Clinical Psychiatry, 74: 122–9.
Connolly, K, Helmer, A, Cristancho, M et al (2012) Effectiveness of transcranial magnetic stimulation in clinical practice post-FDA approval in the United States: results observed with the first 100 consecutive cases of depression at an academic medical center. Journal of Clinical Psychiatry, 73: 567–73.
Couturier, J (2005) Efficacy of rapid-rate repetitive transcranial magnetic stimulation in the treatment of depression: a systematic review and meta-analysis. Journal of Psychiatry & Neuroscience, 30: 83-90.
Dunner, D, Aaronson, S, Sackeim, H et al (2014) A multisite, naturalistic, observational study of transcranial magnetic stimulation for patients with pharmacoresistant major depressive disorder: durability of benefit over a 1-year follow-up period. Journal of Clinical Psychiatry, 75: 1394–401.
Fitzgerald, P, Fountain, S, Daskalakis, Z (2006) A comprehensive review of the effects of rTMS on motor cortical excitability and inhibition. Clinical Neurophysiology, 117: 2584–96.
Fitzgerald, P, Daskalakis, Z (2013) Repetitive Transcranial Magnetic Stimulation Treatment for Depressive Disorders: A Practical Guide. Springer-Verlag.
Furukawa, T (2014) How can we make the results of trials and their meta-analyses using continuous outcomes clinically interpretable? Acta Psychiatrica Scandinavica, 130: 321–3.
Gaynes, BN, Lloyd, SW, Lux, L et al (2014) Repetitive transcranial magnetic stimulation for treatment-resistant depression: a systematic review and meta-analysis. Journal of Clinical Psychiatry, 75: 477–89.
Groppa, S, Oliviero, A, Eisen, A et al (2012) A practical guide to diagnostic transcranial magnetic stimulation: report of an IFCN committee. Clinical Neurophysiology, 123: 858–82.
Gross, M, Nakamura, L, Pascual-Leone, A et al (2007) Has repetitive transcranial magnetic stimulation (rTMS) treatment for depression improved? A systematic review and meta-analysis comparing the recent vs. the earlier rTMS studies. Acta Psychiatrica Scandinavica, 116: 165–73.
Herrmann, L, Ebmeier, K (2006) Factors modifying the efficacy of transcranial magnetic stimulation in the treatment of depression: a review. Journal of Clinical Psychiatry, 67: 1870–6.
Hoogendam, J, Ramakers, GM, Di Lazzaro, V (2010) Physiology of repetitive transcranial magnetic stimulation of the human brain. Brain Stimulation, 3: 95-118.
Horvath, J, Mathews, J, Demitrack, M et al (2010) The NeuroStar TMS device: conducting the FDA approved protocol for treatment of depression. Journal of Visualized Experiments, 45: e2345.
Janicak, P, Nahas, Z, Lisanby, S et al (2010) Durability of clinical benefit with transcranial magnetic stimulation (TMS) in the treatment of pharmaco resistant major depression: assessment of relapse during a 6-month, multisite, open-label study. Brain Stimulation, 3: 187–99.
Kedzior, K, Azorina, V, Reitz, S (2014) More female patients and fewer stimuli per session are associated with the short-term antidepressant properties of repetitive transcranial magnetic stimulation (rTMS): a meta-analysis of 54 sham-controlled studies published between 1997–2013. Neuropsychiatric Disease and Treatment, 10: 727–56.
Kito, S, Fujita, K, Koga, Y (2008) Regional cerebral blood fow changes after low-frequency transcranial magnetic stimulation of the right dorsolateral prefrontal cortex in treatment-resistant depression. Neuropsychobiology, 58: 29-36.
Krstic, J, Buzad&zcar;ic, I, Milanovic, S et al (2014) Low-frequency repetitive transcranial magnetic stimulation in the right prefrontal cortex combined with partial sleep deprivation in treatment-resistant depression: a randomized sham-controlled trial. Journal of ECT, 30: 325–31.
Lam, R, Chan, P, Wilkins-Ho, M et al (2008) Repetitive transcranial magnetic stimulation for treatment-resistant depression: a systematic review and meta-analysis. Canadian Journal of Psychiatry, 53: 621–31.
Lepping, P, Schönfeldt-Lecuona, C, Sambhi, R et al (2014) A systematic review of the clinical relevance of repetitive transcranial magnetic stimulation. Acta Psychiatrica Scandinavica, 130: 326–41.
Luscher, C, Malenka, R (2012) NMDA receptor-dependent long-term potentiation and long-term depression (LTP/LTD). Cold Spring Harbor Perspectives in Biology, 4: a005710.
Martin, JL, Barbanoj, MJ, Schlaepfer, TE et al (2003) Repetitive transcranial magnetic stimulation for the treatment of depression. Systematic review and meta-analysis. British Journal of Psychiatry, 182: 480–91.
Mitchell, P, Loo, C (2006) Transcranial magnetic stimulation for depression. Australian and New Zealand Journal of Psychiatry, 40: 406–13.
Muller, P, Pascual-Leone, A, Rotenberga, A (2012) Safety and tolerability of repetitive transcranial magnetic stimulation in patients with pathologic positive sensory phenomena: a review of literature. Brain Stimulation, 5: 320–9.
NHS Evidence (2012) Depression: Evidence Update April 2012 (Evidence Update 13). National Institute for Health and Care Excellence.
National Institute for Health and Care Excellence (2007) Transcranial Magnetic Stimulation for Severe Depression (IPG242). NICE.
National Institute for Health and Care Excellence (2015a) P346/2 – Repetitive transcranial magnetic stimulation for depression Consultation Comments Table. NICE (https://www.nice.org.uk/guidance/IPG542/documents/consultation-comments-and-responses). Accessed 23 September 2016.
National Institute for Health and Care Excellence (2015b) Repetitive Transcranial Magnetic Stimulation for Depression (IPG542). NICE.
Ren, J, Li, H, Palaniyappan, L et al (2014) Repetitive transcranial magnetic stimulation versus electroconvulsive therapy for major depression: a systematic review and meta-analysis. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 51: 181–9.
Rosedale, M, Lisanby, S, Malaspina, D (2009) The structure of the lived experience for persons having undergone rTMS for depression treatment. Journal of the American Psychiatric Nurses Association, 15: 333–7.
Rossi, S, Hallett, M, Rossini, P et al (2009) Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clinical Neurophysiology, 120: 2008–39.
Sabesan, P, Lankappa, S, Khalifa, N et al (2015) Transcranial magnetic stimulation for geriatric depression: promises and pitfalls. World Journal of Psychiatry, 5: 170–81.
Salomons, T, Dunlop, K, Kennedy, S et al (2014) Resting-state corticothalamic-striatal connectivity predicts response to dorsomedial prefrontal rTMS in major depressive disorder. Neuropsychopharmacology, 39: 488–98.
Schutter, D (2009) Antidepressant efficacy of high-frequency transcranial magnetic stimulation over the left dorsolateral prefrontal cortex in double-blind sham-controlled designs: a meta-analysis. Psychological Medicine, 39: 65-75.
Schutter, D (2010) Quantitative review of the efficacy of slow-frequency magnetic brain stimulation in major depressive disorder. Psychological Medicine, 40: 1789–95.
Slotema, CW, Blom, JD, Hoek, HW et al (2010) Should we expand the toolbox of psychiatric treatment methods to include repetitive transcranial magnetic stimulation (rTMS)? A meta-analysis of the efficacy of rTMS in psychiatric disorders. Journal of Clinical Psychiatry, 71: 873–84.
Tang, Q, Li, G, Wang, A et al (2015) A systematic review for the antidepressant effects of sleep deprivation with repetitive transcranial magnetic stimulation. BMC Psychiatry, 15: 1-9.
Thase, M, Rush, A (1997) When at first you don't succeed: sequential strategies for antidepressant nonresponders. Journal of Clinical Psychiatry, 58 (suppl 13): 23–9.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

BJPsych Advances
  • ISSN: 2056-4678
  • EISSN: 2056-4686
  • URL: /core/journals/bjpsych-advances
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 26 *
Loading metrics...

Abstract views

Total abstract views: 58 *
Loading metrics...

* Views captured on Cambridge Core between 2nd January 2018 - 22nd April 2018. This data will be updated every 24 hours.

Transcranial magnetic stimulation in clinical practice

  • Sheila Hardy, Lorraine Bastick, Alex O'Neill-Kerr, Priyadharshini Sabesan, Sudheer Lankappa and Lena Palaniyappan...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *