University of Manitoba, Canada
Posters & Accepted Abstracts: J Psychiatry
Repetitive trans-cranial magnetic stimulation (r-TMS) is a non-invasive brain stimulation technique using focused magnetic pulses to induce electrical currents in neural tissue. Repeated trains of pulses can cause durable changes in synaptic connections via the mechanisms of neuro-plasticity. Daily sessions of stimulation can exert therapeutic effects that can last weeks to months. The effect of stimulation on neuro-plasticity is dependent on the administered pattern of r-TMS: High-frequency r-TMS (5-20 Hz or higher) has an excitatory result, while low-frequency stimulation (1-5 Hz or lower) is inhibitory. Unlike more invasive methods of brain stimulation, such as electroconvulsive therapy, anesthesia is not required and no diet or activity restrictions are necessary. Therapeutic r-TMS is currently a standard of care in the treatment of major depression with magnetic pulses usually administered over the dorsolateral prefrontal cortex (DLPFC). Some lines of evidence suggest that the therapeutic effects of r-TMS in major depression depend on changes in cortico-striatal-thalamic circuits serving the target region, but the precise mechanism of effect is still under investigation. The efficacy of r-TMS in the treatment of other neuropsychiatric disorders, including obsessive compulsive disorder, addiction, cognitive impairment and auditory hallucination in schizophrenia, is currently being investigated. This presentation will review the application of r-TMS in neuropsychiatric disorders, with a main focus on major depression. Practical considerations, the speculated mechanism of action, efficacy (including response and remission rates) and potential side effects will be discussed in detail.
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