Transcranial Magnetic Stimulation in Neuropsychiatry: An Update

Pharmacological management and behavioral interventions are currently the mainstay in the treatment of neuropsychiatric symptoms in neurological disease. However, a proportion of patients do not have significant improvement with these interventions. Repetitive transcranial magnetic stimulation (rTMS) has been shown to be effective in ameliorating treatment-resistant depression in both clinical trials and practice. Because of the related pathways that have been proposed in neuropsychiatric manifestations of neurological diseases, the therapeutic use of rTMS to alleviate depressive as well as other symptoms has been investigated in Alzheimer disease and mild cognitive impairment, fibromyalgia, multiple sclerosis, Parkinson disease, and cerebrovascular disease. This article reviews the use of rTMS as a treatment modality for neuropsychiatric symptoms in patients with these conditions (Table).