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rTMS for the Treatment of Depression: a Comprehensive Review of Effective Protocols on Right DLPFC

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Abstract

Major depressive disorders (MDDs) are the most common and debilitating diseases worldwide. Repetitive transcranial magnetic stimulation (rTMS) has been widely used as an alternative or adjunctive treatment for different types of depression disorders, including drug-resistant major depressions. Despite controversial findings on the therapeutic outcomes of this technique, the general consent is developing this technique as an alternative treatment for depression disorders. Notwithstanding one protocol of rTMS has been approved by FDA for the acute treatment of major depression, studies are ongoing for finding more efficient protocols. This study aimed to comprehensively overview the effective rTMS protocols applied on left dorsolateral prefrontal cortex DLPFC for MDDs. The databases of PubMed (1985–2015), Web of Sciences (1985–2015), and Google Scholar (1980–2015) were searched using the set terms. The obtained results were screened for the relevant contents by two authors, and the appropriate studies were selected for further review. The most widely used protocols for depression are 1Hz for right and 10Hz for left DLPFC. In addition, the main parameters of these protocols and the main neurophysiological mechanisms of two common frequencies of 1 and 10 Hz are summarized. Different protocols of rTMS, particularly low versus high frequencies, result in significantly different electrophysiological and neurocognitive changes in the subject. Low frequency rTMS modulates frontal alpha power asymmetry and high frequency protocols influence more broader regions and wider electrophysiological characteristics of the brain.

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Acknowledgments

The authors would like to thank research deputy of Ahvaz Jundishapur University of Medical Sciences who financially support the work. We also thank the faculty members of medical physics department, school of medicine for their comment in conducting this study.

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Authors and Affiliations

  1. Department of Medical Physics, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Golestan Blv., Ahvaz, Iran, 6135715794

    Ali Yadollahpour & Ahmad Shakeri

  2. Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

    Seyed Ahmad Hosseini

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  1. Ali Yadollahpour
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  2. Seyed Ahmad Hosseini
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  3. Ahmad Shakeri
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Correspondence to Ali Yadollahpour.

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This study was a part of MSc thesis in Medical Physics, and was financially supported by Ahvaz Jundishapur University of Medical Sciences (Grant No.: 940189).

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Authors have equally contributed in the designing, conducting, and preparation of this manuscript and have no conflict of interests on publishing this manuscript.

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Yadollahpour, A., Hosseini, S.A. & Shakeri, A. rTMS for the Treatment of Depression: a Comprehensive Review of Effective Protocols on Right DLPFC. Int J Ment Health Addiction 14, 539–549 (2016). https://doi.org/10.1007/s11469-016-9669-z

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