Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS)

Jean-Pascal Lefaucheur, Nathalie André-Obadia, Andrea Antal, Samar S Ayache, Chris Baeken, David H Benninger, Roberto M Cantello, Massimo Cincotta, Mamede de Carvalho, Dirk De Ridder, Hervé Devanne, Vincenzo Di Lazzaro, Saša R Filipović, Friedhelm C Hummel, Satu K Jääskeläinen, Vasilios K Kimiskidis, Giacomo Koch, Berthold Langguth, Thomas Nyffeler, Antonio OlivieroFrank Padberg, Emmanuel Poulet, Simone Rossi, Paolo Maria Rossini, John C Rothwell, Carlos Schönfeldt-Lecuona, Hartwig R Siebner, Christina W Slotema, Charlotte J Stagg, Josep Valls-Sole, Ulf Ziemann, Walter Paulus, Luis Garcia-Larrea

1047 Citationer (Scopus)

Abstract

A group of European experts was commissioned to establish guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS) from evidence published up until March 2014, regarding pain, movement disorders, stroke, amyotrophic lateral sclerosis, multiple sclerosis, epilepsy, consciousness disorders, tinnitus, depression, anxiety disorders, obsessive-compulsive disorder, schizophrenia, craving/addiction, and conversion. Despite unavoidable inhomogeneities, there is a sufficient body of evidence to accept with level A (definite efficacy) the analgesic effect of high-frequency (HF) rTMS of the primary motor cortex (M1) contralateral to the pain and the antidepressant effect of HF-rTMS of the left dorsolateral prefrontal cortex (DLPFC). A Level B recommendation (probable efficacy) is proposed for the antidepressant effect of low-frequency (LF) rTMS of the right DLPFC, HF-rTMS of the left DLPFC for the negative symptoms of schizophrenia, and LF-rTMS of contralesional M1 in chronic motor stroke. The effects of rTMS in a number of indications reach level C (possible efficacy), including LF-rTMS of the left temporoparietal cortex in tinnitus and auditory hallucinations. It remains to determine how to optimize rTMS protocols and techniques to give them relevance in routine clinical practice. In addition, professionals carrying out rTMS protocols should undergo rigorous training to ensure the quality of the technical realization, guarantee the proper care of patients, and maximize the chances of success. Under these conditions, the therapeutic use of rTMS should be able to develop in the coming years.

OriginalsprogEngelsk
TidsskriftClinical Neurophysiology
Vol/bind125
Udgave nummer11
Sider (fra-til)2150–2206
Antal sider56
ISSN1388-2457
DOI
StatusUdgivet - nov. 2014

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