A Changing Landscape: Brain Stimulation Therapies


Professor of Psychiatry, WPA Board Member, Skopje, Macedonia

Faculty of Medicine, University Ss. Cyril and Methodius, Skopje, Macedonia

Faculty of Medicine, University Ss. Cyril and Methodius, Skopje, Macedonia


Introduction: Brain stimulation therapies are influencing brain directly with electricity, magnets, or implants to treat different psychiatric disorders.

Electroconvulsive therapy (ECT) is the oldest and most researched with widespread experience of use. Many chemical aspects of brain function are changed during ECT, causing changes in brain chemistry that can reverse symptoms of certain mental illnesses with severe symptoms.

Repetitive trans-cranial magnetic stimulation (rTMS) is a noninvasive, nonconvulsive neurostimulation treatment of depression, with focus on resistant types on medicament treatment.  Recent studies suggest that rTMS is modulating the function in applied both locally and in the associated regions,  leading to a change of cortical metabolism and regional blood flow, and release of neurotransmitters such as serotonin and dopamine , and causing neuroendocrine effects on hormones in the axis of the hypothalamic- pituitary – suprarenal glandula.

Other stimulation therapies – vagus nerve stimulation, magnetic seizure therapy, and deep brain stimulation, are also considered as new treatment options with considerable potential.

Aim: The aim of this study is to review scientific studies on efficiency of brain stimulation therapies used as treatment of mental disorders.

Method: Review of the published studies and researches for brain stimulation treatments.

Results: The results of most studies has founded that ECT is considered as most efficient brain stimulation therapy. However, there are risks and side effects which are limiting its use, beside good treatment results.

Use of TMS therapy is wide spreading, considering rTMS as effective treatment, without major safety concerns. rTMS has been shown to be a safe and well-tolerated procedure that can be an effective treatment for patients with depression. However, common protocols of applications should be established in order to standardize its use.

Beside promising results, more studies should be carrying out in order to better evaluate efficiency of other stimulation therapies.