New avenues in brain stimulation treatments for major depression: Efficacy, acceptability, and translation of novel treatments into clinical practice


In current perspectives on non-invasive brain stimulation techniques for mental disorders novel stimulation techniques, modalities, and increasingly also combinations with other treatment approaches play a key role. The limited efficacy and often unfavourable side effect profile of antidepressant medications—currently the most frequently used approach to treat depression—calls for additional treatment options. Several new nonpharmacological treatment alternatives have been proposed. However, the translation of these alternatives into treatment practice has been proceeding at a slower rate.

The present symposium is therefore organized around three central aims:

– to present results of the comparative efficacy and acceptability of non-invasive brain stimulation techniques for the treatment of major depressive disorder and bipolar depression and;

– to provide insights regarding the difficulty of translating cutting edge research findings into clinical practice. For instance, transcranial magnetic stimulation (TMS) has been found to be efficacious in treatment of depression, and yet its availability in Europe remains limited. We will discuss potential means for improving the availability of TMS at the European level and how the characteristics (e.g. high treatment resistance) of patients enrolled in randomized controlled trials may affect efficacy estimates;

– we will discuss the use of cognitive training to improve cognitive functions in depression and a rationale to combine it with non-invasive brain stimulation. Depression leads to persistent cognitive impairments in up to 50% of patients, resulting in problems in everyday life. To date it is unknown which factors determine the persistence of cognitive problems and there is no state-of-the-art treatment in either acute or remitted depression.

L´Encéphale 45 (Supplement 2): S62, DOI: