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Updated: May 10, 2026
08:20
MRI-guided dmPFC-rTMS as a Treatment for Treatment-resistant Major Depressive Disorder
Published on: August 11, 2015
[Brain stimulation therapies for treatment-resistant depression]
Alberto Vitalucci1, Isabella Coppola, Marta Mirra
1Servizio per i Disturbi Depressivi e d’Ansia, Dipartimento di Neuroscienze, Università di Torino.
Rivista Di Psichiatria
|June 12, 2013
Summary
Treatment-resistant depression (TRD) is a significant health issue. This review examines neurostimulation therapies like electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS) for TRD, highlighting their varying evidence bases and potential as first-line treatments.
Area of Science:
- Neuroscience
- Psychiatry
- Medical Technology
Context:
- Treatment-resistant depression (TRD) affects over 50% of patients, posing a significant public health challenge.
- Current psychopharmacotherapy often fails to achieve complete remission in depressed individuals.
- Neurostimulation therapies offer novel interventions by targeting specific brain regions.
Purpose:
- To review existing evidence for four brain-stimulation therapies: electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), vagus nerve stimulation (VNS), and deep brain stimulation (DBS).
- To explore emerging approaches including ECT, rTMS, and epidural cortical stimulation (EpCS).
- To assess the current evidence base and potential clinical utility of these TRD treatments.
Summary:
- Electroconvulsive therapy (ECT) has the most extensive evidence base among reviewed neurostimulation techniques for TRD.
- Repetitive transcranial magnetic stimulation (rTMS) and vagus nerve stimulation (VNS) have smaller, less consistent evidence bases.
- Deep brain stimulation (DBS) shows emerging efficacy for TRD but remains investigational; ECT and rTMS may be considered first-line treatments in specific cases.
Impact:
- Provides a comprehensive overview of neurostimulation therapies for TRD, aiding clinical decision-making.
- Identifies ECT and rTMS as potentially viable first-line options under certain circumstances.
- Underscores the need for further rigorous, double-blind studies to validate new and existing neurostimulation approaches for TRD.
Related Concept Videos
01:30Electroconvulsive Therapy
Electroconvulsive therapy (ECT), or shock therapy, remains a critical biomedical intervention for severe, treatment-resistant depression. While its origins can be traced back to Hippocrates' observations that malaria-induced convulsions alleviated mental illness, modern ECT has evolved significantly from its earlier, more primitive applications. First introduced in 1938 by Ugo Cerletti and his colleagues, ECT involves inducing controlled seizures using electrical currents. In its early years,...
01:14Brain Imaging
Brain imaging technologies provide critical insights into both the structure and function of the human brain, enabling medical professionals and researchers to diagnose, study, and treat neurological disorders or psychiatric disorders more effectively.
These technologies include computerized axial tomography (CAT or CT scans), positron-emission tomography (PET scans), magnetic resonance imaging (MRI), functional magnetic resonance imaging (fMRI), and Transcranial Magnetic Stimulation (TMS).
These technologies include computerized axial tomography (CAT or CT scans), positron-emission tomography (PET scans), magnetic resonance imaging (MRI), functional magnetic resonance imaging (fMRI), and Transcranial Magnetic Stimulation (TMS).