Non-Invasive Brain Stimulation in Psychiatric Disorders: A Primer. [Review]

TITLE
Non-Invasive Brain Stimulation in Psychiatric Disorders: A Primer. [Review]

SOURCE
Revista Brasileira de Psiquiatria. 41(1):70-81, 2019 Jan-Feb.

AUTHORS
Brunoni AR; Sampaio-Junior B; Moffa AH; Aparicio LV; Gordon P; Klein I; Rios RM; Razza LB; Loo C; Padberg F; Valiengo L.

OBJECTIVE
Non-invasive brain stimulation (NIBS) techniques, such as transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS), are increasingly being used to treat mental disorders, particularly major depression. The aim of this comprehensive review is to summarize the main advances, limitations, and perspectives of the field.

METHODS
We searched PubMed and other databases from inception to July 2017 for articles, particularly systematic reviews and meta-analyses, evaluating the use of NIBS in psychiatric disorders.

RESULTS
We reviewed the mechanisms of action, safety, tolerability, efficacy, and relevant clinical parameters of NIBS. Repetitive TMS is already an established technique for the treatment of depression, and there is theoretically room for further methodological development towards a high-end therapeutic intervention. In contrast, tDCS is a technically easier method and therefore potentially suitable for wider clinical use. However the evidence of its antidepressant efficacy is less sound, and a recent study found tDCS to be inferior to antidepressant pharmacotherapy. Clinical trials using rTMS for other mental disorders produced mixed findings, whereas tDCS use has not been sufficiently appraised.

CONLUSION
The most promising results of NIBS have been obtained for depression. These techniques excel in safety and tolerability, although their efficacy still warrants improvement.