Repetitive transcranial magnetic stimulation (rTMS): a cutting-edge neuropsychiatric therapy

Author(s):
Dr Georgios Mikellides, Panayiota Michael and Dr Marianna Tantele

Duration:
90 minutes

Credits:
1.5

Published:
April 2023

Type:
CPD learning module

CPD domain:
Clinical

Repetitive transcranial magnetic stimulation (rTMS).jpg

Repetitive transcranial magnetic stimulation (rTMS) is an innovative, non-invasive and well-tolerated therapy that may be used as a treatment option for a variety of neuropsychiatric disorders. A large number of studies spanning more than 30 years have shown it to be a powerful neuroscience tool for diagnostic and therapeutic purposes.

rTMS is based on the phenomenon of electromagnetic mutual induction that was first reported by Faraday in 1831. In 1985, Anthony Barker and his colleagues developed the first modern TMS device.

The rTMS technique generates brief electromagnetic pulses via an insulated coil placed over the scalp, which modulates the cortical activity of the brain. Daily rTMS stimulation for several weeks has been shown to be effective in reducing the symptoms of many neuropsychiatric disorders. Moreover, studies have shown that the dorsolateral prefrontal cortex (DLPFC) has a crucial role in improving cognitive performance and, as a result, is a commonly used target area for the treatment of many neuropsychiatric disorders such as depression.

2008 was a significant year for TMS history, as for the first time, the U.S. Food and Drug Administration (FDA) approved a TMS therapy device for the clinical treatment of depression. This approval, together with the National Institute for Health and Care Excellence (NICE) recommendation on TMS for the treatment of depression in 2015, led to the establishment of rTMS as a first-line treatment for patients whose symptoms had not improved following treatment with at least one prior antidepressant medication. This was followed by FDA approval of rTMS for the treatment of migraine, obsessive-compulsive disorder (OCD) and bipolar depression.

This module aims to provide a brief introduction of rTMS therapy and its use in neuropsychiatry.

 

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