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Electroconvulsive Therapy Studies · Journal article
Pharmacotherapy in Psychiatry and Neurology · September 4, 2026
A consensus or society position rather than new primary data.
This narrative review describes an evolving landscape of accelerated, augmented, and precision-targeted TMS protocols in psychiatry and neurology, emphasizing recent clinical milestones including single-day treatment regimens with reported remission rates of 49–72% in treatment-resistant depression and SCAN-targeted approaches in Parkinson's disease showing approximately doubled motor improvement. The review synthesizes evidence across acceleration, pharmacological augmentation, and connectome-informed targeting strategies but explicitly lacks formal meta-analysis or systematic risk-of-bias assessment, positioning it as expert guidance rather than definitive evidence.
Narrative review. Patients with treatment-resistant depression (TRD) and Parkinson's disease; clinical populations targeted by emerging TMS protocols..
Accelerated TMS protocols compress 6-week depression treatment into as little as 5 days. Single-day TMS exploratory studies reported remission rates of 49–72% in treatment-resistant depression. Second sham-controlled RCT confirmed efficacy of SAINT/SNT (Stanford Accelerated Intelligent Neuromodulation Therapy) protocol.
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Clinicians should be aware that accelerated and augmented TMS protocols represent emerging practices with promising but not yet definitive evidence; SAINT/SNT and ONE-D warrant consideration in TRD management pending further validation, and SCAN-targeted approaches may enhance motor outcomes in Parkinson's disease. The review highlights that precision targeting and pharmacological augmentation are reshaping TMS delivery, though implementation at scale remains challenging.
A narrative review synthesizing evidence on evolving TMS protocols and precision approaches across psychiatry and neurology, without formal meta-analysis or risk-of-bias assessment, positioned as expert synthesis for clinicians navigating emerging practice domains.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians should be aware that accelerated and augmented TMS protocols represent emerging practices with promising but not yet definitive evidence; SAINT/SNT and ONE-D warrant consideration in TRD management pending further validation, and SCAN-targeted approaches may enhance motor outcomes in Parkinson's disease. The review highlights that precision targeting and pharmacological augmentation are reshaping TMS delivery, though implementation at scale remains challenging.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
The landscape of neuromodulation therapy is changing rapidly.Accelerated transcranial magnetic stimulation (TMS) protocols now compress 6-week depression treatment courses into as little as 5 days.Exploratory studies of a single-day regimen have reported remission rates of 49-72% in treatment-resistant depression (TRD).Three converging principles define this shift: acceleration (compressing treatment from weeks to hours); augmentation (pharmacologically enhancing synaptic plasticity); and precision targeting (connectomeinformed, individualized site selection).This narrative review synthesizes evidence across all 3 domains, with an emphasis on studies published from 2022 to 2026.Key milestones include a second sham-controlled RCT confirming the efficacy of the SAINT/SNT (Stanford Accelerated Intelligent Neuromodulation Therapy) protocol and the first clinical description of a single-day TMS regimen (ONE-D (Optimized, Neuroplasticity-Enhanced techniques in Depression)) that leverages pharmacological augmentation with D-cycloserine (DCS) to enhance neuroplasticity.Precision strategies, including resting-state functional connectivity magnetic resonance imaging (fcMRI)-guided targeting, closedloop electroencephalography (EEG) systems, and emerging biomarkers, are increasingly complementing anatomical landmark-based methods.We devote particular attention to Parkinson's disease (PD), where the identification of the somato-cognitive action network (SCAN) as a key dysfunctional circuit illustrates how these principles translate into clinical efficacy.SCAN-targeted TMS approximately doubled the magnitude of motor improvement compared with conventional motor cortex stimulation.Finally, we review comparative effectiveness data positioning TMS alongside pharmacotherapy and esketamine, emerging health-economic evidence supporting its cost-effectiveness, and the challenges of scaling precision approaches for routine clinical care.This is a narrative review without a formal risk-of-bias assessment or meta-analytic pooling; limitations of this approach are discussed in the section "Limitations and translational challenges".
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