Recent advances in transcranial magnetic stimulation (TMS) for mental health disorders: A narrative review

Abstract

Since its development in 1985, repetitive Transcranial Magnetic Stimulation (rTMS) has evolved from a novel neuromodulation technique to an FDA-approved treatment for several psychiatric conditions. The paper explains the basic principles of TMS, including its mechanism of action, stimulation parameters, and targeting methods. It details the FDA-approved protocols for three primary indications: major depressive disorder (MDD), obsessive-compulsive disorder (OCD), and smoking cessation. For MDD, multiple protocols targeting the left dorsolateral prefrontal cortex have shown response rates of 38-49%. In OCD, targeting the dorsomedial prefrontal cortex and anterior cingulate cortex has demonstrated a 45% response rate. For smoking cessation, stimulation of the prefrontal cortex and insula has shown promising results in achieving continuous abstinence. The paper also discusses future trends in TMS research and highlights challenges in implementing this technology in low-and-middle income countries like Nigeria, where barriers include insufficient funding, limited mental health infrastructure, and high treatment costs. It concludes that while rTMS offers promising opportunities for personalized treatment approaches, improved mental health services and policy changes are needed to increase its accessibility.