Advances in transcranial magnetic stimulation for psychological symptom management in Parkinson’s disease

Figure 1 Neurophysiological basis and working mechanism of transcranial magnetic stimulation. Transcranial magnetic stimulation (TMS) works by using magnetic fields to influence brain activity through five key mechanisms: Changing neuronal membrane potentials, modifying synaptic plasticity, reshaping neural networks, regulating neurotransmitter systems, and altering neuronal rhythms. High-frequency stimulation (≥ 5 Hz) excites neurons while low-frequency stimulation (≤ 1 Hz) inhibits them. TMS affects major brain networks and molecular pathways including N-methyl-D-aspartic acid receptors, calcium signaling, and brain-derived neurotrophic factor expression. This comprehensive action across multiple neurobiological levels explains TMS’s effectiveness in treating conditions like Parkinson’s disease. DA: Dopamine; 5-HT: 5-hydroxytryptamine; Glu: Glucose; GABA: Gamma-aminobutyric acid; LTP: Long-term potentiation; LTD: Long-term depression; NMDA: N-methyl-D-aspartic acid receptor; BDNF: Brain-derived neurotrophic factor.