Personalised transcranial magnetic stimulation for treatment-resistant depression, depression with comorbid anxiety and negative symptoms of schizophrenia: a narrative review

Singapore Med J. 2024 Oct 1;65(10):544-551. doi: 10.4103/singaporemedj.SMJ-2024-133. Epub 2024 Oct 4.

Abstract

Transcranial magnetic stimulation (TMS) is a promising intervention for treatment-resistant psychiatric disorders. However, conventional TMS typically utilises a one-size-fits-all approach when determining stimulation targets. Recent retrospective brain circuit-based analyses using lesion network mapping have suggested that a left dorsal lateral prefrontal cortex target has a higher efficacy for alleviating depression symptoms, a dorsomedial prefrontal cortex target is more effective for anxiety symptoms, and a rostromedial prefrontal cortex target is effective for schizophrenia-associated psychiatric symptoms. Nonetheless, symptom-specific brain circuit targeting has not been tested prospectively. We conducted a narrative review of selected literature to investigate individualised targeting for TMS and discuss potential future directions to elucidate the efficacy of this approach.

Publication types

  • Review

MeSH terms

  • Anxiety* / therapy
  • Depression / therapy
  • Depressive Disorder, Treatment-Resistant / therapy
  • Humans
  • Precision Medicine / methods
  • Prefrontal Cortex / physiopathology
  • Schizophrenia* / therapy
  • Transcranial Magnetic Stimulation* / methods
  • Treatment Outcome