Repetitive transcranial magnetic stimulation (rTMS) in the treatment of depressive disorder

This article deals with the use of repetitive transcranial magnetic stimulation (rTMS) in the treatment of depressive disorder. The method involves influencing the brain using variable magnetic field. Repetitive TMS is safe, well-tolerated and has very few adverse effects. It is the treatment of depressive disorder where psychiatrists have most experience with this method which, however, is starting to be used for the therapy of other mental disorders as well. Repetitive transcranial magnetic stimulation has been proven to influence cortical excitability and the metabolic activity of neurons. Many studies of its effectiveness in the treatment of depressive disorder have been performed to date and can be divided into three generations. The results of different studies have been summarised in several meta-analyses; the most recent ones in particular show that rTMS constitutes a promising therapeutic method, although a number of questions concerning mainly the exact mechanism of its action, the setting of the most appropriate stimulation parameters and the selection of the most susceptible patients remain unanswered.