RTMS STIMULATION TREATMENT FOR depression a practical guide.

Contents
1: An Introduction to the Basic Principles of TMS and rTMS
	1.1	 Introduction
	1.2	 Overview of TMS Technology
	1.3	 Overview of Repetitive TMS (rTMS) Technology
	1.4	 Sham Stimulation
	1.5	 Noise
	References
2: The History of TMS and rTMS Treatment of Depression
	2.1	 Introduction
	2.2	 Early Attempts to Develop TMS-Like Approaches
	2.3	 The Development of Modern TMS
	References
3: The Mechanism of Action of rTMS
	3.1	 Introduction
	3.2	 Effects of rTMS Assessed in the Motor Cortex
		3.2.1	 Effects on Motor Cortical Excitability
		3.2.2	 Effects on Motor Cortical Inhibition and Facilitation
			Silent Period (SP)
			Paired Pulse Inhibition and Facilitation (ppTMS)
		3.2.3	 Effects of rTMS on Motor Cortical Plasticity
	3.3	 Effects of rTMS Assessed with EEG
	3.4	 Neuroimaging Studies of the Effect of rTMS
		3.4.1	 Imaging of rTMS Effects
		3.4.2	 Imaging of rTMS Effects in Depression
		3.4.3	 Studying Brain Effects of rTMS with Near-Infrared Spectroscopy
	3.5	 Studying Brain Effects of rTMS with Electroencephalography
	3.6	 Effects of rTMS on BDNF
	3.7	 Conclusions
	References
4: Acute rTMS Treatment for Depression
	4.1	 rTMS in Depression: High-Frequency Stimulation
		4.1.1	 Meta-Analysis
		4.1.2	 rTMS Versus ECT
		4.1.3	 Network Meta-Analysis and Umbrella Reviews
		4.1.4	 Real-World Data
		4.1.5	 Summary
	4.2	 Low-Frequency Right-Sided rTMS
	4.3	 Bilateral rTMS
	4.4	 Other Approaches to Standard rTMS Treatment Delivery
	4.5	 Issues with the Conduct of Clinical Trials of rTMS
	4.6	 Conclusions
	References
5: Clinical Indications and Patient Selection
	5.1	 Stage of Illness and Treatment Resistance
		5.1.1	 Clinical Recommendations
	5.2	 Illness Type: Unipolar and Bipolar Depression
		5.2.1	 Clinical Recommendations
	5.3	 Elderly Patients with Depression
		5.3.1	 Clinical Recommendations
	5.4	 Adolescent Depression
		5.4.1	 Clinical Recommendations
	5.5	 Pregnant or Breastfeeding Patients
		5.5.1	 Clinical Recommendations
	5.6	 Comorbid Anxiety
		5.6.1	 Clinical Recommendations
	5.7	 Depression with Psychotic Symptoms
		5.7.1	 Clinical Recommendations
	5.8	 Concurrent Illness: Neurological Disease
		5.8.1	 Clinical Recommendations
	5.9	 Other Factors
	References
6: Practical Issues in Treatment Provision
	6.1	 Introduction
	6.2	 Selection of Treatment Type and Parameters
		6.2.1	 Considerations with High-Frequency Stimulation Left-Sided rTMS
		6.2.2	 Use of Low-Frequency Right-Sided rTMS
		6.2.3	 Sequential Bilateral rTMS
		6.2.4	 Overall Clinical Recommendations
	6.3	 Treatment Scheduling and Duration
		6.3.1	 Less Intense Approaches
		6.3.2	 More Intense Approaches
		6.3.3	 Missing Sessions
		6.3.4	 Treatment Duration
			Clinical Recommendations
	6.4	 Concurrent Treatments
		6.4.1	 Potential Moderation of Efficacy
		6.4.2	 Safety Considerations
			Clinical Recommendations
	References
7: Switching, Continuing, or Ending Treatment
	7.1	 Introduction
	7.2	 How Long Is Long Enough?
		7.2.1	 Patients Showing Improvement
		7.2.2	 Clinical Recommendations
		7.2.3	 Nonresponders
	7.3	 Novel Options
		7.3.1	 Clinical Recommendations
	7.4	 Clinical Decision-Making and the Measurement-Based Care Approach
	References
8: The Use of Deep Transcranial Magnetic Stimulation in Depression
	8.1	 Introduction
	8.2	 Clinical Application of dTMS
	8.3	 Safety of dTMS
	8.4	 Not All Deep TMS Involves the Use of an H-Coil
		8.4.1	 Expanding Applications of dTMS
	8.5	 Conclusion and Clinical Recommendations
	References
9: Theta-Burst Stimulation (TBS)
	9.1	 Introduction
	9.2	 TBS and Its Effects on Brain Function
	9.3	 TBS in Depression
		9.3.1	 Preliminary Clinical Trials
		9.3.2	 TBS in Bipolar Depression
		9.3.3	 The Three-D Trial
		9.3.4	 Other TBS Studies in Depression
	9.4	 Use of Accelerated or Intensive Protocols
	9.5	 Safety of Theta-Burst Stimulation
	9.6	 Practical Implementation
	9.7	 Clinical Recommendation
	References
10: Accelerated and Intensive rTMS Treatment Protocols
	10.1	 Introduction
	10.2	 Twice-Daily rTMS
		10.2.1	 Summary and Clinical Recommendations
	10.3	 Intensive or Accelerated rTMS
	10.4	 Summary and Clinical Recommendations
	References
11: Localization and Targeting of rTMS Treatment of Depression
	11.1	 Introduction
	11.2	 Selection of a Stimulation Target
		11.2.1	 Anatomical Localization
		11.2.2	 Functional Localization
	11.3	 Is There Just One Optimal Target?
	11.4	 How Do We Localize Treatment to the DLPFC?
	11.5	 How Do We Keep the Coil at the Target?
	11.6	 Is Being Highly Targeted Optimal?
	11.7	 Don’t Forget About Coil Orientation
	11.8	 Clinical Application and Recommendations
	References
12: Treatment Intensity, the Resting Motor Threshold and rTMS Treatment Dosing
	12.1	 Dosing and Motor Threshold
	12.2	 Assessment of the Resting Motor Threshold (RMT)
	12.3	 Issues with RMT Assessment
	12.4	 Factors Affecting the RMT
	12.5	 Clinical Recommendations
	References
13: Maintenance and Continuation Treatment
	13.1	 Introduction
	13.2	 Rates of Relapse Following rTMS Treatment
	13.3	 Approaches to Minimize Relapse
	13.4	 Medication Treatment
	13.5	 Psychotherapy
	13.6	 Maintenance rTMS Treatment
		13.6.1	 Standard Maintenance
		13.6.2	 Clustered Maintenance
	13.7	 Other Options: Intermittent Treatment
	13.8	 Repeated rTMS Treatment
	13.9	 Summary and Clinical Recommendations
	References
14: rTMS Associated Adverse Events, Safety and Monitoring
	14.1	 Introduction
	14.2	 Contraindications
	14.3	 Adverse Events
		14.3.1	 Syncope
		14.3.2	 Seizure Induction
	14.4	 Other Potential Safety Concerns
		14.4.1	 Impairment of Cognition
		14.4.2	 Hearing Impairment
		14.4.3	 Potential Histotoxicity or Other Brain Changes
	14.5	 Pregnancy, Breastfeeding
	14.6	 Children and Adolescents
	14.7	 Safety of Operators
	References
15: Side Effects of rTMS Treatment
	15.1	 Introduction
	15.2	 Site or Regional Pain
	15.3	 Headache
	15.4	 Other Transient Side Effects
	15.5	 Psychiatric Complications
	15.6	 Other Considerations
	References
16: The Use of rTMS in Other Psychiatric Disorders
	16.1	 Introduction
	16.2	 Obsessive-Compulsive Disorder (OCD)
		16.2.1	 Summary
	16.3	 Mania
		16.3.1	 Summary
	16.4	 Post-traumatic Stress Disorder
		16.4.1	 Summary
	16.5	 Panic Disorder and Generalized Anxiety Disorder
		16.5.1	 Summary
	16.6	 Schizophrenia
		16.6.1	 Prefrontal Stimulation in Schizophrenia
		16.6.2	 Negative Symptoms
		16.6.3	 Cognition
		16.6.4	 Summary
		16.6.5	 Temporoparietal Cortex rTMS and Auditory Hallucination
		16.6.6	 Summary
	16.7	 Disorders of Addiction
		16.7.1	 Summary
	16.8	 Chronic Pain
		16.8.1	 Summary
	References
17: Equipment and rTMS Program Setup
	17.1	 TMS Equipment
	17.2	 MagVenture
	17.3	 Magstim
	17.4	 Neuronetics
	17.5	 Brainsway
	17.6	 Nexstim
	17.7	 Neurosoft
	17.8	 Others
	17.9	 Treatment Program Establishment
	17.10	 Patient Information and Consent
Index