Repetitive transcranial magnetic stimulation in the treatment of depression

BACKGROUND Transcranial magnetic stimulation (TMS)is a treatment for major depressive disorder that is otherwise resistant to treatment. Although world-leading research in TMS has been conducted in Australia, where it has had some availability for two decades, there is limited familiarity with the treatment in the general medical community. Availability, however, is increasing. OBJECTIVE The aim of this article is to inform general practitioners of some scientific and practical aspects of TMS treatment. DISCUSSION In TMS, an electromagnetic apparatus is used to generate small electric currents in targeted regions of the cortex. Anaesthesia is not required, patients remain conscious and there are no seizure or memory problems. TMS is a first-line treatment for treatment-resistant depression. Current evidence indicates that TMS-induced remission is associated with normalisation of connectivity in cortical-subcortical networks.