Abstrakt
Repetitive transcranial magnetic stimulation (rTMS) of cortical areas in depressed patients has gained increased popularity as a valid treatment option, not only in treatment-resistant depression, within the past years. Several national institutes and guidelines such as the National Institute for Health and Care Excellence (NICE) and the FDA have approved rTMS devices and protocols as second-line treatment for major depressive disorder.
However, in line with the pharmacological options, the amount of responders and remitters for this treatment ranges from approximately 50-66% combined response and remission, depending on the clinical context with rTMS as augmentation for antidepressant medication or/ and psychotherapy (Somani and Kar, 2019). Given the significant proportion of patients being left without a benefit, reliable and objective biomarkers are needed to help the therapist and patient in their decision for the optimal rTMS treatment.
This precision medicine approach seems particularly reasonable for a combined EEG biomarkers/rTMS treatment procedure: rTMS has a direct physical effect on the neural activity at the place of application and beyond while the EEG is the tool of choice for a non-invasive access to the electromagnetic activity of the cortex. Thus, electrophysiological surrogate markers of the ongoing neural oscillations might provide a tailored window for the prediction of rTMS triggered effects.