From the Guidelines
Transcranial Magnetic Stimulation (TMS) is primarily indicated for the treatment of major depressive disorder, as well as other conditions such as post-stroke rehabilitation, substance-use disorders, and certain neuropsychiatric disorders like obsessive compulsive disorder and post-traumatic stress disorder.
Indications for TMS
- Major Depressive Disorder: TMS has been FDA-approved for the treatment of major depressive disorder, particularly in patients who have not responded to other treatments 1.
- Post-Stroke Rehabilitation: TMS has been shown to be effective in improving motor function and other deficits in stroke survivors, with Level A evidence supporting its use for hand function and Level B evidence for motor rehabilitation 2.
- Substance-Use Disorders: TMS has been explored as a potential treatment for substance-use disorders, with some studies suggesting its effectiveness in reducing cravings and improving cognitive function 1.
- Neuropsychiatric Disorders: TMS has been used to treat conditions such as obsessive compulsive disorder, post-traumatic stress disorder, and schizophrenia, often in combination with other therapies like cognitive behavioral therapy 3.
Key Considerations
- Stimulation Parameters: The effectiveness of TMS depends on various stimulation parameters, including frequency, intensity, and duration, which must be carefully tailored to the individual patient and condition being treated 3.
- Targeting Approach: The choice of targeting approach, including the use of neuronavigation and electric field modeling, can significantly impact the efficacy of TMS treatment 3.
From the Research
Indications for Transcranial Magnetic Stimulation (TMS)
The indications for TMS include:
- Treatment-resistant unipolar major depressive disorder, as approved by the US Food and Drug Administration 4
- Obsessive-compulsive disorder, also approved by the US Food and Drug Administration 4, 5
- Medication-resistant depression, with high-frequency stimulation of the left dorsolateral prefrontal cortex 6
- Neuropsychiatric symptoms of developmental disorders with inflammatory aspects, such as autism, Tourette syndrome, and obsessive-compulsive disorder 5
- Nicotine cessation in adults, as cleared by the FDA 5
- Migraine in individuals aged 12 and above, as cleared by the FDA 5
- Pain, with high-frequency rTMS of the primary motor cortex contralateral to the pain, having level A evidence for definite efficacy 7
- Anxiety disorders, with level C evidence for possible efficacy 7
- Schizophrenia, with level B recommendation for probable efficacy of high-frequency rTMS of the left dorsolateral prefrontal cortex for negative symptoms 7
- Stroke, with level B recommendation for probable efficacy of low-frequency rTMS of contralesional primary motor cortex in chronic motor stroke 7
- Tinnitus and auditory hallucinations, with level C evidence for possible efficacy of low-frequency rTMS of the left temporoparietal cortex 7
Potential Future Indications
Research is ongoing to explore the potential of TMS in treating other conditions, including: