Slow transcranial magnetic stimulation, long-term depotentiation, and brain hyperexcitability disorders

Am J Psychiatry. 2002 Jul;159(7):1093-102. doi: 10.1176/appi.ajp.159.7.1093.


Objective: Many clinical syndromes in neuropsychiatry suggest focal brain activation. Repetitive transcranial magnetic stimulation (rTMS) has been proposed as a method for selectively altering neural activity.

Method: Studies assessing effects of "slow" rTMS, administered up to once per second, in normal people and in those with pathological conditions are reviewed. The findings are compared with those of animal studies examining long-term depression and long-term depotentiation through direct electrical stimulation of cortical tissue.

Results: Data suggest that slow rTMS reduces cortical excitability, both locally and in functionally linked cortical regions. Preliminary studies of patients with focal dystonia, epileptic seizures, and auditory hallucinations indicate symptom reductions following slow rTMS. Long-term depotentiation exhibits many features congruent with those of slow rTMS, including frequency dependence, spread to functionally linked cortical regions, additive efficacy, and extended duration of effects.

Conclusions: Slow rTMS offers a new method for probing and possibly treating brain hyperexcitability syndromes. Further studies linking slow rTMS to animal models of neuroplasticity are indicated.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Animals
  • Brain / physiology*
  • Brain / physiopathology
  • Cerebral Cortex / physiology
  • Cerebral Cortex / physiopathology
  • Depressive Disorder / physiopathology
  • Depressive Disorder / therapy*
  • Dystonic Disorders / physiopathology
  • Dystonic Disorders / therapy*
  • Electric Stimulation
  • Epilepsies, Partial / physiopathology
  • Epilepsies, Partial / therapy*
  • Hallucinations / physiopathology
  • Hallucinations / therapy*
  • Humans
  • Long-Term Potentiation / physiology*
  • Models, Neurological
  • Neuronal Plasticity / physiology
  • Rats
  • Transcranial Magnetic Stimulation / therapeutic use*