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Obsessive Compulsive Spectrum Disorders · Journal article
The International Journal of Neuropsychopharmacology · September 1, 2026
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This narrative review synthesizes translational evidence (animal models, neuroimaging, immunological markers) and early-phase clinical trial data to propose that accelerated transcranial magnetic stimulation (aTMS) achieves faster antidepressant and broader psychiatric effects through cumulative neuroplasticity and anti-inflammatory mechanisms. The work is exploratory and hypothesis-generating; it does not report a controlled trial outcome or quantify clinical efficacy, and thus cannot yet guide practice.
Journal article. Patients with treatment-resistant depression, obsessive–compulsive disorder, addiction, and impulse-control disorders (from emerging evidence cited; specific cohort sizes not stated). Intervention: Accelerated transcranial magnetic stimulation (aTMS) delivering multiple daily sessions in condensed timeframes, including high-dose sequential stimulation and SAINT-like accelerated paradigms.
Preclinical and neuroimaging studies show repeated high-frequency stimulation at short intervals induces cumulative plasticity across cortical–subcortical circuits aTMS has shown rapid and robust antidepressant effects in treatment-resistant depression, often achieving remission within days TMS demonstrates anti-inflammatory effects, including reductions in peripheral inflammatory markers (IL-6, TNF-α) and modulation of microglial activity
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Clinicians should recognize aTMS as a conceptually promising approach to accelerate symptom relief in depression and other psychiatric disorders, but should await controlled trials reporting efficacy, safety, and optimal dosing parameters before adopting accelerated protocols into routine practice. Current evidence is mechanistic and preliminary.
This is a narrative review integrating preclinical mechanisms and early-phase clinical trial data without reporting a primary empirical finding, controlled outcome, or definitive clinical result.
As stated by the source record.
Clinicians should recognize aTMS as a conceptually promising approach to accelerate symptom relief in depression and other psychiatric disorders, but should await controlled trials reporting efficacy, safety, and optimal dosing parameters before adopting accelerated protocols into routine practice. Current evidence is mechanistic and preliminary.
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What is missing. This record has no reported figures. That is a gap in the analysis, not a judgement about the study.
Abstract Background Conventional repetitive transcranial magnetic stimulation (rTMS) requires daily sessions over several weeks, limiting accessibility and delaying clinical improvement. Accelerated TMS (aTMS), delivering multiple daily sessions in condensed timeframes, offers a strategy to increase treatment efficiency and achieve faster therapeutic effects. However, the mechanistic basis and optimal dosing parameters of accelerated protocols remain under investigation. Aims & Objectives The aim of this work is to elucidate the translational mechanisms underlying accelerated TMS (aTMS) and to evaluate its clinical applicability across psychiatric disorders. The specific objectives are: Method This presentation integrates data from neuroanatomy, functional connectivity, animal models, and early-phase clinical trials. Mechanisms related to synaptic plasticity, metaplasticity, cumulative dosing, network-level modulation, and immunological effects were reviewed alongside outcomes from high-dose sequential stimulation and SAINT-like accelerated paradigms. Results Preclinical and neuroimaging studies show that repeated high-frequency stimulation delivered at short intervals induces cumulative plasticity across cortical–subcortical circuits. Accelerated schedules enhance modulation of fronto-limbic and cortico-striatal networks, supporting rapid symptom improvement. Growing evidence also highlights a significant anti-inflammatory effect of TMS, including reductions in peripheral inflammatory markers (e.g., IL-6, TNF-α) and modulation of microglial activity in animal studies. These immunomodulatory actions may contribute to the accelerated therapeutic response, particularly in disorders characterized by neuroinflammation such as depression and OCD. Clinically, aTMS has shown rapid and robust antidepressant effects in treatment-resistant depression, often achieving remission within days. Emerging evidence supports its applicability in obsessive–compulsive disorder, addiction, and impulse-control disorders. Moderators such as age, brain network architecture, baseline connectivity, and inflammatory status appear to influence treatment outcomes Discussion & Conclusions Accelerated TMS represents an important advancement in neuromodulation, offering faster clinical improvement and broader psychiatric applications. Its therapeutic effects likely arise from synergistic mechanisms involving enhanced neuroplasticity and meaningful anti-inflammatory modulation. Translational evidence supports the development of individualized dosing strategies informed by neural and inflammatory biomarkers. Future work should refine stimulation schedules, optimize target selection, and integrate aTMS into precision psychiatry frameworks.
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