Transcranial Magnetic Stimulation : The First Quarter Century

Over the last quarter century, transcranial magnetic stimulation (TMS) has been researched and applied in clinical practice in the treatment of major depressive disorder (MDD). More than 100 placebo-controlled studies and 20 metaanalyses have shown this treatment to be effective in treatment resistant depression (TRD). This revolutionary modality uses electromagnetism to therapeutically impact brain cortex; it causes few side effects. TMS corrects abnormalities in brain connectivity, and such corrections correlate with changes in mood. TMS is complimentary and not a replacement for electroconvulsive therapy (ECT), a comprehensive service will provide both techniques. The efficacy of TMS is expected to increase with new stimulation protocols. Currently used as a second line treatment, TMS is likely to become a first line option. Currently, expertise is limited to those working in particular clinics - there is a need/call for training to be more widely available. Keywords: connectivity; electroconvulsive therapy; major depressive disorder; treatment resistant depression; transcranial magnetic stimulation