Department of Psychiatry and Medical Psychology, Ghent University.
Ghent Experimental Psychiatry (GHEP) Lab.
Curr Opin Psychiatry. 2019 Sep;32(5):409-415. doi: 10.1097/YCO.0000000000000533.
After three decades of clinical research on repetitive transcranial magnetic stimulation (rTMS), major depressive disorder (MDD) has proven to be the primary field of application. MDD poses a major challenge for health systems worldwide, emphasizing the need for improving clinical efficacy of existing rTMS applications and promoting the development of novel evidence-based rTMS treatment approaches.
Several promising new avenues have been proposed: novel stimulation patterns, targets, and coils; combinatory treatments and maintenance; and personalization and stratification of rTMS parameters, and treatment of subpopulations.
This opinion review summarizes current knowledge in the field and addresses the future direction of rTMS treatment in MDD, facilitating the establishment of this clinical intervention method as a standard treatment option and continuing to improve response and remission rates, and take the necessary steps to personalize rTMS-based treatment approaches.
经过三十年的重复性经颅磁刺激（rTMS）临床研究，重度抑郁症（MDD）已被证明是其主要的应用领域。MDD 对全球卫生系统构成了重大挑战，这强调了需要提高现有 rTMS 应用的临床疗效，并促进新的基于证据的 rTMS 治疗方法的发展。
已经提出了几种有前途的新途径：新型刺激模式、靶点和线圈；联合治疗和维持；rTMS 参数的个性化和分层，以及亚人群的治疗。
本观点综述总结了该领域的现有知识，并探讨了 rTMS 在 MDD 中的未来治疗方向，这有助于将该临床干预方法确立为标准治疗选择，并继续提高反应率和缓解率，同时采取必要步骤使 rTMS 为基础的治疗方法个性化。
