Medication-resistant major depressive disorder (TRD) is one of the leading causes of suffering and disability. Transcranial magnetic stimulation (TMS) is a potential treatment method for TRD, which can be targeted relatively accurately. Localization of relevant functional target regions in the brain would likely increase efficacy of TMS. We have developed a new targeting method based on functional imaging of connections of the brain and modeling of the effects of TMS. In small pilot studies these methods increased efficacy of TMS considerably. We are thus asking 160 patients referred to TMS for TRD in the Helsinki region to participate in a controlled study, in which possible sources of error can be ruled out and the methods further developed. Furthermore, we aim to address cognitive and brain level mechanisms of good response to TMS. Such studies may result in more effective and better tolerated treatment of TRD and help to develop treatments for other brain disorders.

2023

2027