Repetitive transcranial magnetic stimulation in panic disorder

Abstract

The available treatment methods for panic disorder (PD; pharmacotherapy and cognitive behavioral therapy) are well documented as safe and effective. However, few patients remain free of panic attacks or in complete remission. With the advancement in the understanding of the neurobiological mechanisms involved in PD, new treatments have been proposed. One such method is transcranial magnetic stimulation (TMS), a non-invasive method of focal brain stimulation. TMS is based on the Faraday’s law of electromagnetic induction, where an electric current is influenced by the magnetic field into the brain, inducing an electric current that depolarizes or hyperpolarizes neurons. Unlike for depression, only few studies are available today investigating the therapeutic effects of rTMS for PD. Thus, this chapter aimed to provide information on the current research approaches and main findings regarding the therapeutic use of rTMS in the context of PD. So far, there is no conclusive evidence of the efficacy of rTMS as a treatment for PD. While positive results were found in most of studies, various treatment parameters, such as location, frequency, intensity and duration have been used unsystematically, making diffi- cult the interpretation of results and providing little guidance about which treatment parameters (i.e., the stimulus location and frequency) may be more useful for the PD treatment. Therefore, further studies are needed to clearly determine the role of rTMS in PD treatment.