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TMS Approaches for Major Depression: Is There a Clear Winner?

By MedScape | Jan 16, 2017

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There are few differences in clinical efficacy and tolerability with different types of repetitive transcranial magnetic stimulation (rTMS) for major depression, new research shows. A systematic review of randomized clinical trials comparing the efficacy and tolerability of rTMS modalities showed they were largely equal but, to some extent, favored bilateral rTMS and priming low-frequency rTMS in the treatment of major depressive disorder (MDD).

“In clinical practice, physicians often choose high-frequency stimulation because there have been more studies using this approach, but we can now say that this is not necessarily the case; physicians might also use other forms of stimulation such as bilateral and low frequency,” lead author, Andre R. Brunoni, MD, PhD, Institute of Psychiatry, University of Sao Paulo, Brazil, told Medscape Medical News.

The authors note that although several types of rTMS have been investigated in the treatment of MDD, little is known about their comparative efficacy.
TMS induces changes in brain activity according to the applied frequency. High-frequency (HF)-rTMS (usually ≥ 10 Hz) induces an increase, whereas low-frequency (LF)-rTMS (usually ≤ 1 Hz) has the opposite effect.

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