Repetitive transcranial magnetic stimulation of dorsomedial Prefrontal cortex (dmPFC- r TMS) in the treatment of depressive disorder. Review of clinical trials
Abstract
Background: Repetitive transcranial magnetic (rTMS) is non-invasive neurostimulation method used in the treatment of major depression. Mostly applied is stimulation over the dorsolateral prefrontal cortex using figure eight (butterfly) coil.
In the last years, there is available new design of coil (double-cone coil) enabling deeper brain structures (dorsomedial prefrontal cortex, dorsal anterior cingulate) involved in pathophysiology of depression. Methods: The authors systematically searched the Medline database (https://pubmed.ncbi.nlm.nih.gov) according to predefined criteria and keywords.
They identified open-label and double-blind studies evaluated efficacy and safety of dorsomedial prefrontal cortex repetitive transcranial magnetic stimulation (dmPFC-rTMS). Results: A total of 7 open-label and 4 double-blind studies were found.
Double-cone stimulation has been proven as safe with good tolerability. Limited number of studies, their heterogeneity and inconclusive results do not allow do not allow to make a definite decision on effectiveness of dmPFC-rTMS in the treatment of depression.
Conclusion: dmPFC-rTMS represents a promising tool for the treatment of major depression. However, further, adequately designed studies are needed to assess its effectiveness and position in the treatment of depression.