Neurophysiological and neuropsychiatric aspects of transcranial magnetic stimulation [Aspetti neurofisiologici e neuropsichiatrici della stimolazione magnetica transcranica]

Introduction: The authors review the literature in the field of Transcranial Magnetic Stimulation (TMS). Materials and methods: For this purpose a PubMed search was performed. Additional information was gained by cross-referencing from papers found in the data base. Results: Data from controlled studies as well as supplementary information from relevant review articles pertinent to the topic were used. History and the basics of TMS and repetitive Transcranial Magnetic Stimulation (rTMS) are presented. The ability of rTMS to non-invasively modulate higher cognitive functions such as learning and memory developed to a new exciting field. TMS, in fact, allows to transiently disrupt ongoing cortical processing, thus helping to enlighten the causal role of a specific brain area in a certain observable behaviour. Finally, rTMS clinical effectiveness in mood disorders, anxiety disorders, schizophrenic psychoses and Parkinson's disease, as well as in pain syndrome, is discussed. Conclusions: RTMS in concert with functional neuroimaging methods allows to analyse neuronal networks. Long-Term Potentiation (LTP) and Long-Term Depression (LTD) are phenomena seen in preclinical studies after rTMS, thus reflecting plastic modulation of the brain. In fact, changes in brain plasticity are supposed to be putative mechanisms underlying the pathophysiology of psychiatric diseases like major depression. © 2009 Elsevier Srl. All rights reserved.