Luan D, Zhao MG, Shi YC, Li L, Cao YJ, Feng HX, Zhang ZJ. Mechanisms of repetitive transcranial magnetic stimulation for anti-depression: Evidence from preclinical studies. World J Psychiatr 2020; 10(10): 223-233 [PMID: 33134113 DOI: 10.5498/wjp.v10.i10.223]
Corresponding Author of This Article
Zhi-Jun Zhang, MD, PhD, Doctor, Full Professor, Department of Neurology, Affiliated Zhongda Hospital, Research Institution of Neuropsychiatry, School of Medicine, Southeast University, No. 87 Dingjiaqiao, Nanjing 210009, Jiangsu Province, China. janemengzhang@vip.163.com
Research Domain of This Article
Psychiatry
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Di Luan, Ya-Chen Shi, Ling Li, Yu-Jia Cao, Zhi-Jun Zhang, Department of Neurology, Affiliated Zhongda Hospital, Research Institution of Neuropsychiatry, School of Medicine, Southeast University, Nanjing 210009, Jiangsu Province, China
Ming-Ge Zhao, Hai-Xia Feng, Department of Nursing, School of Medicine, Southeast University, Nanjing 210009, Jiangsu Province, China
Zhi-Jun Zhang, Department of Psychology, Xinxiang Medical University, Xinxiang 453003, Henan Province, China
Zhi-Jun Zhang, Mental Health Center, Zhejiang University School of Medicine, Hangzhou 310013, Zhejiang province, China
Author contributions: Luan D and Zhang ZJ developed the framework of the paper; Luan D wrote the first draft; all authors worked in subsequent drafts, confirmed the last version before submission, and approved the final manuscript.
Supported bythe National Key R and D Program of China, No. 2016YFC1306700; The Key Projects of National Natural Science Foundation of China, No. 81830040; Science and Technology Program of Guangdong, China, No. 2018B030334001; and Program of Excellent Talents in Medical Science of Jiangsu Province, China, No. JCRCA2016006.
Conflict-of-interest statement: The authors deny any conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Zhi-Jun Zhang, MD, PhD, Doctor, Full Professor, Department of Neurology, Affiliated Zhongda Hospital, Research Institution of Neuropsychiatry, School of Medicine, Southeast University, No. 87 Dingjiaqiao, Nanjing 210009, Jiangsu Province, China. janemengzhang@vip.163.com
Received: June 16, 2020 Peer-review started: June 16, 2020 First decision: July 30, 2020 Revised: August 11, 2020 Accepted: September 2, 2020 Article in press: September 2, 2020 Published online: October 19, 2020 Processing time: 126 Days and 15.1 Hours
Abstract
This review summarizes the anti-depressant mechanisms of repetitive transcranial magnetic stimulation in preclinical studies, including anti-inflammatory effects mediated by activation of nuclear factor-E2-related factor 2 signaling pathway, anti-oxidative stress effects, enhancement of synaptic plasticity and neurogenesis via activation of the endocannabinoid system and brain derived neurotrophic factor signaling pathway, increasing the content of monoamine neurotransmitters via inhibition of Sirtuin 1/monoamine oxidase A signaling pathway, and reducing the activity of the hypothalamic-pituitary-adrenocortical axis. We also discuss the shortcomings of transcranial magnetic stimulation in preclinical studies such as inaccurate positioning, shallow depth of stimulation, and difficulty in elucidating the neural circuit mechanism up- and down-stream of the stimulation target brain region.
Core Tip: Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for major depressive disorder. This paper reviews the anti-depressant mechanisms of rTMS that have been found in preclinical studies in recent years and discusses the shortcomings of TMS in preclinical studies.
