Controversy: Repetitive transcranial magnetic stimulation or transcranial direct current stimulation shows efficacy in treating psychiatric diseases (depression, mania, schizophrenia, obsessive-complusive disorder, panic, posttraumatic stress disorder)

Mark S. George, Frank Padberg, Thomas E. Schlaepfer, John P. O'Reardon, Paul B. Fitzgerald, Ziad H. Nahas, Marco A. Marcolin

Research output: Contribution to journalArticle

Abstract

Brain imaging studies performed over the past 20 years have generated new knowledge about the specific brain regions involved in the brain diseases that have been classically labeled as psychiatric. These include the mood and anxiety disorders, and the schizophrenias. As a natural next step, clinical researchers have investigated whether the minimally invasive brain stimulation technologies (transcranial magnetic stimulation [TMS] or transcranial direct current stimulation [tDCS]) might potentially treat these disorders. In this review, we critically review the research studies that have examined TMS or tDCS as putative treatments for depression, mania, obsessive-complusive disorder, posttraumatic stress disorder, panic disorder, or schizophrenia. (Separate controversy articles deal with using TMS or tDCS to treat pain or tinnitus. We will not review here the large number of studies using TMS or tDCS as research probes to understand disease mechanisms of psychiatric disorders.) Although there is an extensive body of randomized controlled trials showing antidepressant effects of daily prefrontal repetitive TMS, the magnitude or durability of this effect remains controversial. US Food and Drug Administration approval of TMS for depression was recently granted. There is much less data in all other diseases, and therapeutic effects in other psychiatric conditions, if any, are still controversial. Several issues and problems extend across all psychiatric TMS studies, including the optimal method for a sham control, appropriate coil location, best device parameters (intensity, frequency, dosage, and dosing schedule) and refining what subjects should be doing during treatment (activating pathologic circuits or not). In general, TMS or tDCS as a treatment for most psychiatric disorders remains exciting but controversial, other than prefrontal TMS for depression.

Original languageEnglish (US)
Pages (from-to)14-21
Number of pages8
JournalBrain Stimulation
Volume2
Issue number1
DOIs
StatePublished - 2009

Fingerprint

Transcranial Magnetic Stimulation
Panic Disorder
Post-Traumatic Stress Disorders
Bipolar Disorder
Psychiatry
Schizophrenia
Depression
Drug Approval
Transcranial Direct Current Stimulation
Tinnitus
Brain
Brain Diseases
Therapeutic Uses
Anxiety Disorders
Mood Disorders
Research
Neuroimaging
Antidepressive Agents
Appointments and Schedules
Therapeutics

Keywords

  • clinical trials
  • depression
  • schizophrenia
  • tDCS
  • TMS

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)
  • Biophysics
  • Medicine(all)

Cite this

Controversy : Repetitive transcranial magnetic stimulation or transcranial direct current stimulation shows efficacy in treating psychiatric diseases (depression, mania, schizophrenia, obsessive-complusive disorder, panic, posttraumatic stress disorder). / George, Mark S.; Padberg, Frank; Schlaepfer, Thomas E.; O'Reardon, John P.; Fitzgerald, Paul B.; Nahas, Ziad H.; Marcolin, Marco A.

In: Brain Stimulation, Vol. 2, No. 1, 2009, p. 14-21.

Research output: Contribution to journalArticle

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