Transcranial magnetic stimulation.
OBJECTIVE
To present state-of-the-art transcranial magnetic stimulation (TMS) therapy, especially when it is used in psychiatric disorders, on the basis of an exhaustive literature search from 2006 to date (June 2008) on TMS papers published in Medline and Embase. Other references and comments from our own experience started 8 years ago have also been taken into account.


RESULTS
The mechanism of action of TMS is now better understood. There is strong evidence of the safety and tolerability of TMS when standard protocols are used. The efficacy of the stimulation of the dorsolateral prefrontal cortex in depression is well documented, and there is evidence of the utility of TMS in posttraumatic stress disorder, in persistent auditory hallucinations in schizophrenia and in attention-deficit disorder with hyperactivity.


CONCLUSIONS
There is enough evidence of the efficacy and safety of TMS in depression to include this technique in the therapeutic protocols of major depression. However, more research is needed on the use of this technique in other psychiatric and nonpsychiatric disorders such as posttraumatic stress disorder, persistent auditory hallucinations, attention-deficit disorder with hyperactivity and tinnitus.
Department of Psychiatry, Complutense University, Madrid, Spain. jli@lopez-ibor.com
Juan J
JJ
López-Ibor
María-Inés
MI
López-Ibor
José I
JI
Pastrana
D001289:Attention Deficit Disorder with Hyperactivity / Q000628:therapy; D006212:Hallucinations / Q000628:therapy; D006801:Humans; D001523:Mental Disorders / Q000628:therapy*; D012559:Schizophrenia / Q000628:therapy; D013313:Stress Disorders, Post-Traumatic / Q000628:therapy; D050781:Transcranial Magnetic Stimulation