Cited by 89Transcranial Magnetic Stimulation StudiesElectroconvulsive Therapy StudiesTreatment of Major Depression

Consensus review and considerations on TMS to treat depression: A comprehensive update endorsed by the National Network of Depression Centers, the Clinical TMS Society, and the International Federation of Clinical Neurophysiology

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Trapp, Nicholas T., Purgianto, Anthony, Taylor, Joseph J., Singh, Manpreet K., Oberman, Lindsay M., Mickey, Brian J., Youssef, Nagy A., Solzbacher, Daniela +14 more·2025·Clinical Neurophysiology

Abstract

• Repetitive transcranial magnetic stimulation (rTMS) is a safe and effective treatment for depressive disorders. • New forms of rTMS such as intermittent theta burst (iTBS) are non-inferior to standard rTMS for treating depression. • Attempts to enhance efficacy (accelerated iTBS, MRI guidance, neuroplasticity modulators) show promising early findings. This article updates the prior 2018 consensus statement by the National Network of Depression Centers (NNDC) on the use of transcranial magnetic stimulation (TMS) in the treatment of depression, incorporating recent research and clinical developments. Publications on TMS and depression between September 2016 and April 2024 were identified using methods informed by PRISMA guidelines. The NNDC Neuromodulation Work Group met monthly between October 2022 and April 2024 to define important clinical topics and review pertinent literature. A modified Delphi method was used to achieve consensus. 2,396 abstracts and manuscripts met inclusion criteria for review. The work group generated consensus statements which include an updated narrative review of TMS safety, efficacy, and clinical features of use for depression. Considerations related to training, roles/responsibilities of providers, and documentation are also discussed. TMS continues to demonstrate broad evidence for safety and efficacy in treating depression. Newer forms of TMS are faster and potentially more effective than conventional repetitive TMS. Further exploration of targeting methods, use in special populations, and accelerated protocols is encouraged. This article provides an updated overview of topics relevant to the administration of TMS for depression and summarizes expert, consensus opinion on the practice of TMS in the United States.

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Authors
Trapp, N. T., Purgianto, A., Taylor, J. J., Singh, M. K., Oberman, L. M., Mickey, B. J., Youssef, N. A., Solzbacher, D., Zebley, B., Cabrera, L. Y., Conroy, S., Cristancho, M., Richards, J. R., Flood, M. J., Barbour, T., Blumberger, D. M., Taylor, S. F., Feifel, D., Reti, I. M., McClintock, S. M., Lisanby, S. H., & Husain, M. M.
Affiliations
  • University of Iowa (US)
  • Brigham and Women's Hospital (US)
  • University of California, Davis (US)
  • National Institute of Mental Health (US)
  • University of Utah (US)
  • Pine Rest Christian Mental Health Services (US)
  • NewYork–Presbyterian Hospital (US)
  • Pennsylvania State University (US)
  • Indiana University School of Medicine (US)
  • University of Pennsylvania (US)
  • Harvard University (US)
  • Centre for Addiction and Mental Health (CA)
  • University of Michigan (US)
  • University of California San Diego (US)
  • Johns Hopkins University (US)
  • The University of Texas Southwestern Medical Center (US)
  • Duke University (US)
Corresponding author
Trapp, Nicholas T.
Venue
Clinical Neurophysiology
Publisher
Elsevier BV
Published
2025-02
Volume
170
Pages
206-233
ISSN
1388-2457 (ISSN-L)
OpenAlex
W4405585988
Cited by
89
References
316
Citations by year
2026: 65 · 2025: 23 · 2024: 1
FWCI
13.89
Type
journal article
Language
en
Open access
Locations
  • Clinical Neurophysiology (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • PubMed Central (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • IUScholarWorks (Indiana University) (submittedVersion)
Funders
  • National Institute of Mental Health (R21MH128815, R01MH112815, 5R01MH121542, K23MH129829, 1K23MH125145, R01MH113929)
  • American Foundation for Suicide Prevention (5R01MH121542, DIG-1\u2013134\u201322)
  • Canadian Institutes of Health Research (R01MH112815, R21MH128815, R01MH1192850)
  • American Academy of Child and Adolescent Psychiatry
  • Patient-Centered Outcomes Research Institute
  • Fondation Brain Canada
  • ACMH Foundation
  • National Institutes of Health
  • Campbell Family Mental Health Research Institute
  • Brain and Behavior Research Foundation (21875, 31081)
  • Columbia University
  • National Institute on Alcohol Abuse and Alcoholism (1R21AA030372)
  • U.S. Department of Health and Human Services
Topics
  • Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
  • Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Keywords
repetitive transcranial magnetic stimulation, depression, intermittent theta burst stimulation, TMS safety, clinical documentation, treatment-resistant depression, special populations
MeSH terms
Depression, Humans, Neurophysiology, Societies, Medical, Consensus, Transcranial Magnetic Stimulation

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