| Abstract [eng] |
Pharmacological treatment of psychiatric disorders and psychotherapy only partially compensate the burden of these disorders. New treatment approaches are being researched to effectively treat psychiatric disorders and one of the new methods is transcranial magnetic stimulation. The aim of this thesis was to review, analyse recent scientific literature and summarise the application and clinical aspects of transcranial magnetic stimulation in treating mental disorders. Publications were searched in MEDLINE (PubMed), Google Scholar, Web of Science, PsychINFO databases, from which 154 literature sources were selected. Transcranial magnetic stimulation may be an effective treatment for depressive disorders, depressive episode of bipolar affective disorder, positive (auditory hallucinations) and negative symptoms of schizophrenia, obsessive–compulsive disorder, post-traumatic stress disorder, and alcohol and nicotine addictions. For treating depressive disorders high–frequency stimulation targeting the left dorsolateral prefrontal cortex, low–frequency stimulation targeting the right dorsolateral prefrontal cortex or bilateral stimulation is recommended for 4–6 weeks. Response to treatment should be assessed at least after 20 sessions of transcranial magnetic stimulation and symptoms should be monitored for recurrence after the successful treatment. Low-frequency stimulation targeting the dorsolateral prefrontal cortex or temporoparietal cortex is recommended for auditory hallucinations and high-frequency stimulation targeting these areas is recommended for negative symptoms of schizophrenia. For obsessive-compulsive disorder 1–2 weeks long low–frequency stimulation targeting the dorsolateral prefrontal cortex is recommended. High–frequency stimulation could also be used in the treatment of post–traumatic stress disorder, but data is lacking on which brain region transcranial magnetic stimulation would have the greatest therapeutic effect. Stimulation targeting the dorsolateral prefrontal cortex may also be used in the treatment of psychoactive substance addictions. However, the suggestions made in this review are preliminary, as larger, high–quality randomised trials and meta-analyses are needed in the future to provide a strong rationale for use of transcranial magnetic stimulation in the treatment of psychiatric disorders. |
