Neuropsychiatric aspects of transcranial magnetic stimulation (TMS)

The authors review the literature in the field of transcranial magnetic stimulation (TMS). For this purpose, a search using PubMed was performed. Additional information was gained by cross-referencing from papers found in the database. Data from controlled studies as well as supplementary information from review articles pertinent to the topic were used. History and the basics of TMS and rTMS (repetitive transcranial magnetic stimulation) are presented. The ability of rTMS to noninvasively modulate higher cognitive functions such as learning and memory developed to a new exciting field. The new method allows to transiently disrupt ongoing cortical processing thus helping to enlighten the causal role of a certain brain area in a certain observable behavior. rTMS in concert with neuroimaging methods like PET, SPECT or fMRI thus allows to analyze neuronal networks. Long-term potentiation (LTP) and long-term depression (LTD) are phenomena seen in preclinical studies after rTMS, thus reflecting plastic modulation of the brain. In fact, changes in brain plasticity are discussed to be putative mechanisms underlying the etiology of psychiatric diseases like depression. rTMS treatment in depression, mania, anxiety disorders, schizophrenic psychosis and Parkinson's disease as well as in pain syndromes are discussed in the following.