Repeated transcranial magnetic stimulation in the treatment of depression (literature review)

Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for depression. Numerous studies have presented evidence that rTMS is indeed a promising treatment, but its effectiveness is often modest. In this paper, we consider this evidence and discuss several reasons that can explain the modest therapeutic efficacy in most of them, including: the most frequent use of only left-sided stimulation of the dorsolateral prefrontal cortex (DLPFC), which may not be optimal when compared with bilateral stimulation; the use of suboptimal methods for targeting DLPFC (that is, the 5 cm anterior method used), thereby limiting the potential of therapy only to the target form of treatment a short (from 2 to 4 weeks) duration of therapy and intensity of stimulation during the procedure may not be sufficient if the distance between the coil and the cortex, on which the rTMS-induced antidepressant response is not taken into account. Future research aimed at eliminating the aforementioned limitations is needed to potentially optimize the effectiveness of this promising treatment for depression, especially its pharmacoresistant forms...