Illuminating posterior targets for TMS beyond the prefrontal cortex.

Area of Science:

• Neuroscience
• Psychiatry
• Neuromodulation

Background:

• Transcranial Magnetic Stimulation (TMS) is an emerging therapy for psychiatric disorders.
• Current FDA-cleared TMS psychiatric indications focus on frontal lobe targets.
• Historically, TMS targets were based on lesion studies and prefrontal cortex imaging.

Purpose of the Study:

• To explore the role of posterior brain regions in psychiatric disorders.
• To review preliminary evidence for TMS targeting posterior regions.
• To consider the risks and benefits of stimulating posterior brain areas.

Main Methods:

• Literature review of neuroimaging studies implicating posterior regions.
• Synthesis of preliminary data from existing TMS trials targeting posterior areas.
• Perspective on the potential therapeutic applications of posterior TMS.

Main Results:

• Neuroimaging studies consistently implicate posterior regions (occipital cortex, precuneus, IPL, cerebellum) in psychiatric disorders.
• Few TMS clinical trials have targeted these posterior regions to date.
• Preliminary evidence suggests potential but requires further investigation.

Conclusions:

• Posterior brain regions may represent novel targets for TMS therapy in psychiatry.
• Further research is needed to evaluate the efficacy and safety of posterior TMS.
• Expanding TMS targets beyond the frontal lobes could broaden therapeutic options for psychiatric illness.