Abstract
Non-invasive brain stimulation has been increasingly recognized for its potential
as an investigational, diagnostic and therapeutic tool across the clinical neurosciences.
Transcranial magnetic stimulation (TMS) is a non-invasive method of focal neuromodulation.
Diagnostically, TMS can be used to probe cortical excitability and plasticity, as
well as for functional mapping. Therapeutically, depending on the pattern employed,
TMS can either facilitate or inhibit stimulated cortex potentially modulating maladaptive
physiology through its effects on neuroplasticity. Despite this potential, applications
of TMS in neurology have only been approved for diagnostic clinical neurophysiology,
pre-surgical mapping of motor and language cortex, and the treatment of migraines.
In this article, we discuss the principles of TMS and its clinical applications in
neurology, including experimental applications in stroke rehabilitation, seizures,
autism spectrum disorder, neurodegenerative disorders, movement disorders, tinnitus,
chronic pain and functional neurological disorder. To promote increased cross-talk
across neurology and psychiatry, we also succinctly review the TMS literature for
the treatment of major depression and obsessive compulsive disorder. Overall, we argue
that larger clinical trials that are better informed by circuit-level biomarkers and
pathophysiological models will lead to an expansion of the application of TMS for
patients cared for by neurologists.
Keywords
neuromodulation - transcranial magnetic stimulation - neuropsychiatry
