Published online Oct 19, 2020. doi: 10.5498/wjp.v10.i10.223
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
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.