[Treatment of depression using transcranial stimulation (TMS)and neuroimaging].

Transcranial magnetic stimulation (TMS) is a non-invasive technique for stimulating the cerebral cortex and altering cortical and subcortical activities. High-frequency stimulation (5-20 Hz) has been shown to enhance cortical excitability, and low-frequency stimulation (1 Hz) to inhibit cortical excitability. High-frequency stimulation over the left dorsolateral prefrontal cortex (DLPFC) and low-frequency stimulation over the right DLPFC have both been shown to be antidepressant effects in the treatment of depression. Our previous studies have revealed that high-frequency stimulation over the left DLPFC increases cerebral blood flow (CBF) in the left prefrontal cortex, orbitofrontal cortex, anterior cingulate, and subcallosal area (subgenual cingulate cortex) with improvement of depression, and low-frequency stimulatin over the right DLPFC decreases CBF in the right prefrontal cortex, orbitofrontal cortex, and subcallosal area with improvement of depression. Theses findings suggest that there might be differences in the antidepressant effects between high-frequency stimulation over the left DLPFC and low-frequency stimulation over the right DLPFC, raising a possibility that more appropriate approaches could be taken for the treatment of depression by using neuroimaging, and tailor-made medicine with TMS could be provided depending on each patient with depression.