Transcranial magnetic stimulation for treatment-resistant depression
The first works, in the mid-1990s, that showed that electromagnetic waves could stimulate neurons have led to the discovery that transcranial magnetic stimulation could alter mood states. Swiftly, a repetitive form of transcranial magnetic stimulation (rTMS) has been used as a therapy for depression and is now well established as part of treatment-resistant depression (TRD) therapeutic armamentarium. Although widely accepted and used in clinical routine, the field of rTMS in depression is undergoing intense development in both basic research and its clinical application. In this chapter, we first introduce the theoretical basis of rTMS and its hypothesized mechanisms of action. Then, we present a state of the art of rTMS practice in the indication of TRD. Finally, we open the discussion on the future of this technique through the use of biomarkers, the optimization of stimulation parameters, and maintenance therapy.
