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Clinical Off-Label Use of Deep Transcranial Magnetic Stimulation in Psychiatric Conditions

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Abstract

Purpose of review

Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive neuromodulation approach to psychiatric treatment that is FDA approved for the management of major depressive disorder (MDD) and obsessive compulsive disorder (OCD). Standard TMS appears to exert biological effects by inducing current in the cortex more shallowly than deep TMS (dTMS); it may be that this modality of treatment differs from standard TMS. Given the potential difference in the manner in which dTMS stimulates the targeted brain regions, it is reasonable to review and summarize the various off-label and experimental applications of this variation of TMS.

Recent findings

Deep TMS has demonstrated promise in treating mood disorders including bipolar depression and PTSD, but it is clear that more work is needed to clarify the utility of dTMS compared with rTMS. Future work may help delineate the role dTMS plays in addressing a wide spectrum of psychiatric illnesses. In addition, direct fundamental work is needed to characterize any effectiveness of dTMS in schizophrenia, anxiety, and autism spectrum disorder.

Summary

Overall, neuromodulation holds promise for treating a variety of psychiatric conditions but more extensive works aimed at understanding the mechanisms and applicability are sorely needed. Continued efforts in understanding the unique application of dTMS may pave the way for future methodologies that could enhance treatment options for both mood and thought disorder.

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Funding

This work was supported by the Medical Research Foundation of Oregon under grant APSYCO236 (BJC).

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  1. Achieve TMS, 1675 SW Marlow Ave., Suite 206, Portland, OR, 97225, USA

    Brandon J. Cornejo & Shannon Boyce

  2. Veterans Affairs Portland Health Care System, 3710 SW US Veterans Hospital Rd, Portland, OR, 97239, USA

    Brandon J. Cornejo, Holly McCready, Sarah Rabin & Laura Dennis

  3. Oregon Health Sciences University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA

    Brandon J. Cornejo, Holly McCready & Laura Dennis

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Correspondence to Brandon J. Cornejo.

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The authors who are currently part-time employees of Achieve TMS use Brainsway dTMS equipment. They otherwise have no interests or connections to Brainsway whatsoever.

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Cornejo, B.J., McCready, H., Rabin, S. et al. Clinical Off-Label Use of Deep Transcranial Magnetic Stimulation in Psychiatric Conditions. Curr Treat Options Psych 7, 576–588 (2020). https://doi.org/10.1007/s40501-020-00230-y

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