Transcranial Magnetic Stimulation as an Alternative Treatment for Depression in Charcot–Marie–Tooth Disease

Abstract

Charcot–Marie–Tooth (CMT) disease is a hereditary peripheral neuropathy leading to progressive motor and sensory dysfunction. Patients with CMT frequently experience psychiatric comorbidities, particularly depression due to their physical limitations and decreased quality of life. Conventional pharmacological treatments for depression may be ineffective or poorly tolerated in this patient population, necessitatin alternative therapeutic approaches. The case of an 18-year-old female with a prior diagnosis of CMT who developed recurrent, treatment-resistant depression is presented. Despite multiple pharmacological interventions, including fluoxetine and mirtazapine, the patient exhibited persistent depressive symptoms and medication intolerance. Given the limited efficacy of pharmacotherapy, she underwent transcranial magnetic stimulation (TMS) therapy as an alternative treatment option. The patient received intermittent theta burst stimulation targeting the left dorsolateral prefrontal cortex for 20 sessions over 4 weeks. Depression severity was assessed using the Hamilton Depression Rating Scale 17 (HAM-D17) and the Patient Health Questionnaire-9 (PHQ-9) before and after TMS treatment. Following TMS therapy, the patient demonstrated significant clinical improvement, with a reduction of over 50% in HAM-D17 and PHQ-9 scores. Additionally, she reported enhanced sleep quality and overall well-being, with no major adverse effects observed. This case highlights the potential of TMS as an effective and well-tolerated treatment for depression in patients with CMT. Given the challenges associated with pharmacological treatments in this population, TMS may serve as an alternative non-invasive intervention for individuals with CMT and comorbid depression. Further research is warranted to establish standardized protocols and efficacy in larger cohorts.

Cite this article as: Garip B. Transcranial magnetic stimulation as an alternative treatment for depression in Charcot–Marie–Tooth disease. Neuropsychiatr Invest. 2025, 63, 0006,

doi:10.5152/NeuropsychiatricInvest.2025.25006.