A Review on Neuronavigated Repetitive Transcranial Magnetic Stimulation and Its Antidepressant Effect
- Author:
Myeongju KIM
1
;
Yumi SONG
;
Chaewon SUH
;
Jiyoung MA
;
Gahae HONG
;
Jungyoon KIM
Author Information
1. Department of Brain and Cognitive Sciences, Ewha W. University, Seoul
- Publication Type:Review Article
- From:
Journal of the Korean Society of Biological Therapies in Psychiatry
2020;26(2):101-115
- CountryRepublic of Korea
-
Abstract:
Repetitive transcranial magnetic stimulation (rTMS) is widely recognized as an effective and noninvasive neuromodulation for treating depression, and has been applied in a wide range of clinical settings. However, previous studies often reported inconsistent antidepressant effects that may be due to differences in the rTMS protocols such as coil placement. The typical simulation site for rTMS depression protocol is the left dorsolateral prefrontal cortex (DLPFC). Targeting the exact site of the left DLPFC while considering individual brain structure has been challenging due to the non-invasive nature of rTMS. Several researchers have applied various targeting methods to overcome the abovementioned issue. Most of the previous studies have applied the “5-cm rule” or the “international 10-20 system,” which is easily applicable. Recently, researchers started to apply a neuronavigation system that targets the stimulation site based on neuroimaging of each individual. Pros and cons of targeting methods have been discussed in terms of validity and reliability of targeting stimulation sites, differences in treatment responses, as well as considerations of individual characteristics. Therefore, the current review focuses on the targeting methods of stimulation site and the treatment effects of depression in previous studies. For discussion, we divided neuronavigation methods into using fixed coordinates and using individualized targets. Furthermore, the limitations of each targeting method are discussed that may potentially contribute to the development of the optimal rTMS protocol for depression treatment.
