Major depressive disorder is a common mental health disease that severely impacts an individual’s quality of life. In addition to limiting psychosocial function, major depressive disorder, in more than one-third of patients, is treatment-resistant. This means that there is a failure to achieve remission of depression symptoms after being treated with various strategies. 

In 2008, the FDA approved transcranial magnetic stimulation (TMS) as a treatment option for major depressive disorder. TMS is a non-invasive procedure that works by directing recurring magnetic energy pulses at specific areas of the brain involved in mood control. The result is long-lasting effects on how the brain functions which can ease depression symptoms and improve mood. 

Until recently, TMS treatments have lacked precision. It has generally been known that the dorsolateral prefrontal cortex is involved in emotional regulation. Armed with this information, TMS targets somewhere in this broad region in an attempt to stimulate certain brain circuits. To narrow the location of an individual’s dorsolateral prefrontal cortex, researchers implemented the use of MRI technology. This proved to provide better remission rates for depression symptoms, but a more personal and individualistic approach could still be taken. 

Because a one-size-fits-all approach is not the final answer, a deeper look was taken at targeting different areas of the brain for certain symptoms of depression. Leveraging the data from MRI testing, and comparing it to healthy individuals, researchers mapped two specific brain circuits that mediated responses to different symptoms. The first circuit, when stimulated, reduced symptoms such as sadness and suicidality. The second circuit, when stimulated, reduced symptoms of irritability and insomnia. 

By identifying these circuits and being more precise with where TMS targets, greater remission from depression symptoms occurred. With continued studies and research utilizing MRI technology in conjunction with TMS, more promise comes for those with treatment-resistant depression. 

Learn more about TMS on our website or feel free to contact us using the brief form below to find out if you or a loved one is a candidate. If you suffer from treatment-resistant depression and TMS is not the right solution for you, we may have another treatment that is more appropriate for your symptoms and long-term goals.


About the Author

Kimberly Sandberg Aloha Integrative Health
Kim Sandberg is the owner and founder of Aloha Integrative Health and a Certified Registered Nurse Anesthetist. She has two advanced degrees: a Masters of Science in Nursing as a Nurse Anesthetist and a Doctor of Nursing Practice. She has worked in a variety of settings, though the biggest impact on Kim and her work came from her 28 years of service in the Navy Reserve.

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