Abstract
High frequency repetitive transcranial magnetic stimulation (rTMS) and vagus nerve stimulation (VNS) are both techniques of stimulating the brain in a more focused way to treat refractory depression. While rTMS is a relatively non-invasive technique that stimulates a region of the cortex by means of very strong short magnetic impulses, VNS is a technique using an implanted neurostimulator with current intensities between 0.25 and 1.5 mA. Their respective success rates have been described in the literature by various authors [3] [5] [7]. In nonresponders or patients with VNS-related side-effects, the extent to which a sequential combination treatment of VNS and rTMS can contribute to an improvement in the symptoms must be examined on an individual basis. Within the present case report, we discuss the effectiveness of a sequentially combined VNS/rTMS therapy.
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