Repetitive transcranial magnetic stimulation: an innovative medical therapy

Repetitive Transcranial Magnetic Stimulation (rTMS) is an innovative, non-invasive and well tolerated method that could be used as a treatment option for a variety of neuropsychiatric disorders. A large number of studies, for more than 30 years, have demonstrated that is a powerful neuroscience tool for diagnostic and therapeutic purposes. rTMS is based on the phenomenon of electromagnetic mutual induction, that firstly reported by Michael Faraday in 1831. Later, in 1985, Anthony Barker and his colleagues developed the first modern transcranial magnetic stimulation (TMS) device. rTMS uses brief electromagnetic pulses generated by an insulated coil, placed over the scalp. This technique has the ability to modulate the cortical activity of the brain. Daily rTMS stimulation for several weeks has been shown to be effective in reducing symptoms of many neuropsychiatric disorders. Moreover, studies have shown that dorsolateral prefrontal cortex (DLPFC) has a crucial role in improving cognitive performance and, as a result, is a commonly used target area for the treatment of many neuropsychiatric disorders such as depression. 2008 was a significant year for TMS history, as FDA approved for first time a TMS therapy device for the clinical treatment of depression. This approval as well as the National Institute for Health and Care Excellence (NICE) recommendation on TMS for the treatment of depression in 2015 lead to the establishment of rTMS as a first-line treatment for patients that failed in at least one prior antidepressant medication, followed by FDA approvals for the treatment of migraines and OCD. This paper aims to enhance further some of the clinical usefulness of rTMS.