The impact of accelerated high frequency rTMS on brain neurochemicals in treatment-resistant depression: Insights from 1H MR spectroscopy

Repetitive transcranial magnetic stimulation (rTMS) is an evidence-based non-invasive clinical tool to treat patients suffering from major depression (Lefaucheur et al. 2014). Compared to electroconvulsive therapy (ECT) the application of rTMS seems rather benign: subjects are fully awake, no anesthesia or additional medication is needed. Only minor side effects - if any - are to be expected (George et al. 2013). Nevertheless, to induce enough current to excite cortical neurons at a depth of 2–2.5 cm beneath the scalp, the changing current which passes through the coil develops an electromagnetic field of about 1.5–3 Tesla (Hallett 2000; George and Belmaker 2007).

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