transcranial magnetic stimulation(TMS) for treating depression
Last reviewed 02/2021
- NICE state that "..evidence on repetitive transcranial magnetic stimulation
for depression shows no major safety concerns. The evidence on its efficacy
in the short-term is adequate, although the clinical response is variable..."
- repetitive transcranial magnetic stimulation (rTMS) does not need anaesthesia
and can be done on an outpatient basis. A purpose-made electromagnetic coil
is held against the scalp with the intention of inducing electric currents
in the cerebral cortex. Imaging may be used to help target specific areas
of the brain. Treatment is usually considered for patients with depression
that has not responded to antidepressant medication or patients for whom antidepressants
are not suitable
- in rTMS, repetitive pulses of electromagnetic energy are delivered at various
frequencies or stimulus intensities. Conventional rTMS is a repetition of
individual pulses at a pre-set interval (train of pulses), whereas theta-burst
rTMS is a repetition of short bursts of pulses at a pre-set interval (train
of bursts). Stimulation can either be delivered unilaterally, over the left
or right dorsolateral prefrontal cortex, or bilaterally over both cortices.
Bilateral stimulation may be done sequentially or simultaneously
- treatment with rTMS usually comprises daily sessions lasting about 30 minutes, typically for 2 to 6 weeks
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