Transcranial magnetic stimulation (TMS) for geriatric depression
Open accessAbstract
Background The prevalence of treatment-resistant geriatric depression (GD) highlights the need for treatments that preserve cognitive functions and recognize polypharmacy in elderly, yet effectively reduce symptom burden. Transcranial magnetic stimulation (TMS) is a proven intervention for treatment-resistant depression in younger adults but the efficacy of TMS to treat depressed older adults is still unclear. This review provides an updated view on the efficacy of TMS treatment for GD, discusses methodological differences between trials in TMS application, and explores avenues for optimization of TMS treatment in the context of the ageing brain. Methods A systematic review was conducted to identify published literature on the antidepressant efficacy of TMS for GD. Databases PubMed, Embase, and PsycINFO were searched for English language articles in peer-reviewed journals in March 2021. Results Seven randomized controlled trials (RCTs) (total n = 260, active n = 148, control n = 112) and seven uncontrolled trials (total n = 160) were included. Overall, we found substantial variability in the clinical response, ranging from 6.7% to 54.3%. Conclusions The reviewed literature highlights large heterogeneity among studies both in terms of the employed TMS dosage and the observed clinical efficacy. This highlights the need for optimizing TMS dosage by recognizing the unique clinical features of GD. We showcase a set of novel approaches for the optimization of the TMS protocol for depression and discuss the possibility for a standardized TMS protocol tailored for the treatment of GD.
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In older adults, most rTMS studies to date have been limited by suboptimal stimulation parameters, small sample sizes, and insufficient treatment durations.
“However, in older adults, most rTMS studies to date have been limited by suboptimal stimulation parameters, small sample sizes, and insufficient treatment durations.6”
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- Authors
- Cappon, D., den Boer, T., Jordan, C., Yu, W., Metzger, E., & Pascual-Leone, A.
- Affiliations
- Harvard University (US)
- Hebrew SeniorLife (US)
- Corresponding author
- Cappon, Davide
- Venue
- Ageing Research Reviews
- Publisher
- Elsevier BV
- Published
- 2022-02
- Volume
- 74
- Pages
- 101531
- ISSN
- 1568-1637 (ISSN-L)
- PMC
- PMC8996329
- OpenAlex
- W3216489878
- Cited by
- 97
- References
- 142
- Citations by year
- 2026: 16 · 2025: 34 · 2024: 18 · 2023: 18 · 2022: 11
- FWCI
- 1.37
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Ageing Research Reviews (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (P01AG031720, R01AG059089, R24AG06142)
- Topics
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Keywords
- transcranial magnetic stimulation, geriatric depression, treatment-resistant depression, older adults, antidepressant efficacy, brain aging, cognitive preservation, polypharmacy
- MeSH terms
- Aged, Aging, Depression, Humans, Treatment Outcome, Transcranial Magnetic Stimulation
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