Annals of Indian Academy of Neurology
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REVIEW: MANAGEMENT UPDATES (REVIEWS ON ADVANCES IN TREATMENT)
Year : 2011  |  Volume : 14  |  Issue : 4  |  Page : 245-251

Repetitive transcranial magnetic stimulation in psychiatry


1 Department of Psychiatry, M.K.C.G. Medical College, Berhampur, Orissa, India
2 Department of Psychiatry, Mahatma Gandhi Medical College and Research Institute, Pudduchery, India
3 Department of Psychiatry, Kasturba Medical College, Manipal, Karnataka, India
4 Department of Psychiatry, Central Institute of Psychiatry, Kanke, Ranchi, Jharkhand, India

Correspondence Address:
Samir Kumar Praharaj
Department of Psychiatry, Kasturba Medical College, Manipal, Karnataka - 576 104
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-2327.91935

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Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive and relatively painless tool that has been used to study various cognitive functions as well as to understand the brain-behavior relationship in normal individuals as well as in those with various neuropsychiatric disorders. It has also been used as a therapeutic tool in various neuropsychiatric disorders because of its ability to specifically modulate distinct brain areas. Studies have shown that repeated stimulation at low frequency produces long-lasting inhibition, which is called as long-term depression, whereas repeated high-frequency stimulation can produce excitation through long-term potentiation. This paper reviews the current status of rTMS as an investigative and therapeutic modality in various neuropsychiatric disorders. It has been used to study the cortical and subcortical functions, neural plasticity and brain mapping in normal individuals and in various neuropsychiatric disorders. rTMS has been most promising in the treatment of depression, with an overall milder adverse effect profile compared with electroconvulsive therapy. In other neuropsychiatric disorders such as schizophrenia, mania, epilepsy and substance abuse, it has been found to be useful, although further studies are required to establish therapeutic efficacy. It appears to be ineffective in the treatment of obsessive compulsive disorder. There is a paucity of studies of efficacy and safety of rTMS in pediatric and geriatric population. Although it appears safe, further research is required to optimize its efficacy and reduce the side-effects. Magnetic seizure therapy, which involves producing seizures akin to electroconvulsive therapy, appears to be of comparable efficacy in the treatment of depression with less cognitive adverse effects.


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