Personalized Transcranial Magnetic Stimulation in Psychiatry

Transcranial magnetic stimulation (TMS) is a noninvasive brain stimulation technique that allows for modulating the activity of local neural populations and related neural networks. TMS is touted as a viable intervention to normalize brain activity and alleviate some psychiatric symptoms. However, TMS interventions are known to be only moderately reliable, and the efficacy of such therapies remains to be proven for psychiatric disorders other than depression. We review new opportunities to personalize TMS interventions using neuroimaging and computational modeling, aiming to optimize treatment to suit particular individuals and clinical subgroups. Specifically, we consider the prospect of improving the efficacy of existing TMS interventions by parsing broad diagnostic categories into biologically and clinically homogeneous biotypes. Biotypes can provide distinct treatment targets for optimized TMS interventions. We further discuss the utility of computational models in refining TMS personalization and efficiently establishing optimal cortical targets for distinct biotypes. Personalizing cortical stimulation targets, treatment frequencies, and intensities can improve the therapeutic efficacy of TMS and potentially establish noninvasive brain stimulation as a viable treatment for psychiatric symptoms.