ABSTRACT
OBJECTIVES: Transcranial magnetic stimulation (TMS) affects the brain by non-invasively
stimulating the cerebral cortex and inducing electrical currents in neurons.
The powerful magnetic field acts as a vector that passes across the scalp
and the skull, and then converts into an electrical energy within the brain.
Originally used in neurophysiology, TMS has since been applied in a variety
of neuropsychiatric conditions, including mood disorders. Imaging studies
in mood-disordered patients have pointed to dysfunctional limbic and prefrontal
cortex activity. TMS researchers have thus postulated that dorsolateral prefrontal
cortex (DLPFC) stimulation might change brain activity both locally and in
paralimbic areas through transynaptic connections, and alter mood. METHODS:
We will describe the technology of TMS, its applications to date, and explore
its mechanisms of action. RESULTS: Several clinical trials have demonstrated
TMS effects on mood in health and disease. There is a growing consensus that
TMS has antidepressant effects, although little is known about the role played
by a variety of stimulation parameters such as the intensity or frequency
of stimulation. One study has found an antimanic effect of right prefrontal
TMS. CONCLUSION: TMS is relatively safe; however, much more research is needed
before TMS can be integrated into routine clinical practice.
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