Brain stimulation techniques for the treatment of depression and other psychiatric disorders

The aim of this paper was to review the development of repetitive transcranial magnetic stimulation (rTMS), magnetic seizure therapy (MST), vagal nerve stimulation (VNS), deep brain stimulation (DBS) and other recent brain stimulation techniques for their potential use in the treatment of a range of psychiatric disorders.

A considerable number of studies have been conducted to investigate the efficacy of rTMS. Although there are considerable problems with this research base, globally the studies suggest that rTMS has antidepressant efficacy. However, more research is required to define the most effective way of applying this technique. There is a much smaller research base supporting the use of VNS and to date the research suggests that only a minority of patients benefit from this procedure. Considerably more research is required in the use of the other techniques which at this stage have been tested only to a very small degree. It is likely that one, and possibly a number, of the new brain stimulation techniques will become available clinically in the psychiatric armamentarium in the coming years. However, considerable research is still required to establish efficacy and define the appropriate place in clinical practice for these treatment approaches.