Early rTMS Integration for Major Depressive Disorder: A Circuit Based Model of Plasticity Failure and Treatment Sequencing
Year: 2026
Type: other
Abstract: This paper proposes an early‑pathway neuromodulation model for major depressive disorder, arguing that repetitive transcranial magnetic stimulation (rTMS) should be considered earlier in care rather than after multiple medication failures. The manuscript outlines a three‑group comparative framework, integrates current evidence on rTMS efficacy and safety, and examines how medication load, neuroplasticity windows, and psychotherapy timing interact with neuromodulation outcomes. The goal is to provide a clearer conceptual rationale for sequencing rTMS within stepped‑care systems while highlighting areas where empirical clarification is still needed. This work is intended to support clinicians, researchers, and systems planners who are re‑evaluating traditional medication‑first algorithms and exploring more efficient, patient‑centered treatment pathways.
Author: Chad Thomas
Language: English
Subfield: Neurology
Field: Neuroscience
Domain: Life Sciences
Open Access status: green
OpenAlex ID: W7219859942