Repetitive transcranial magnetic stimulation as a neuropsychiatric tool: Present status and future potential

Robert M. Post, Tim A. Kimbrell, Una D. McCann, Robert T. Dunn, Elizabeth A. Osuch, Andrew M. Speer, Susan R.B. Weiss

Research output: Contribution to journalArticlepeer-review

Abstract

Repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising therapeutic intervention in the treatment of affective disorders. The differences in the type of electrical stimulation required for therapeutic efficacy by rTMS and electroconvulsive therapy (ECT) are discussed. In contrast to ECT, rTMS would not appear to require the generation of a major motor seizure to achieve therapeutic efficacy. Accordingly, it carries the potentially important clinical advantages of not requiring anesthesia and of avoiding side effects such as transient memory loss. Preclinical studies on long-term potentiation (LTP) and long-term depression (LTD) in hippocampal and amygdala slices, as well as clinical data from neuroimaging studies, have provided encouraging clues for potential frequency-dependent effects of rTMS. Preliminary evidence from positron emission tomography (PET) scans suggests that higher frequency (20 Hz) stimulation may increase brain glucose metabolism in a transsynaptic fashion, whereas lower frequency (1 Hz) stimulation may decrease it. Therefore, the ability of rTMS to control the frequency as well as the location of stimulation, in addition to its other advantages, has opened up new possibilities for clinical explorations and treatments of neuropsychiatric conditions.

Original languageEnglish (US)
Pages (from-to)39-59
Number of pages21
JournalJournal of ECT
Volume15
Issue number1
StatePublished - 1999
Externally publishedYes

Keywords

  • Affective disorders
  • Brain imaging
  • Depression
  • Electroconvulsive therapy
  • Long-term depression
  • Long-term potentiation
  • Mechanisms
  • Positron emission tomography
  • Repetitive transcranial magnetic stimulation

ASJC Scopus subject areas

  • Neuroscience (miscellaneous)
  • Psychiatry and Mental health

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