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Updated: May 22, 2026
Conventional Repetitive Transcranial Magnetic Stimulation for Depression: A Step-by-Step Protocol
Published on: November 21, 2025
Resting motor threshold changes and clinical response to prefrontal repetitive transcranial magnetic stimulation in
Jean-Baptiste Pretalli1, Magali Nicolier, Gilles Chopard
1Department of Clinical Psychiatry, University Hospital of Besançon, Besançon, France.
Aims:
Several variables are able to influence the antidepressant effects of repetitive transcranial magnetic stimulation (rTMS), particularly the intensity of stimulation, which is generally expressed according to the resting motor threshold (RMT). The aim of our study was to investigate whether or not RMT changes during the treatment of resistant depression by rTMS and whether these fluctuations could alter treatment outcome.
Methods:
Seventy-five inpatients suffering from unipolar or bipolar treatment-resistant depression and who had been antidepressant-free or taking a stable antidepressant drug and a daily dose of benzodiazepine for at least a month received a left prefrontal rTMS session once a day for 10 days at 10 Hz and 95% RMT.
Results:
For the whole group, no significant fluctuation of RMT was observed between the first and the second week of rTMS treatment. However, RMT increased, decreased or remained constant throughout treatment depending on the patient. These RMT changes influenced the outcome of the 10 sessions concerning the severity of depressive and anxiety symptoms, measured by the Beck Depression Inventory and State Trait Anxiety, respectively.
Conclusions:
Our results justify calculating RMT regularly, and suggest that its variations play a role in treatment outcome.
