{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T09:08:51Z","timestamp":1784538531942,"version":"3.55.0"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"\n Introduction<\/jats:title>\n Transcranial magnetic stimulation (TMS) is a non-invasive neuromodulation technique with demonstrated efficacy in the treatment of multiple psychiatric and neurological disorders. ExoTMS represents an evolution in TMS system design, developed to optimize focused brain stimulation while enhancing patient comfort and operational efficiency. By leveraging established neuroplastic mechanisms in a more patient-centered format, ExoTMS may represent a scalable advancement when compared to conventional TMS systems. This review examines the technological characteristics, safety profile, and therapeutic implications of ExoTMS, with particular attention to patient-reported outcomes, treatment comfort, and safety.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Eight studies were included, comprising 182 active-treated participants who received stimulation at effective intensity levels. Treatment protocols consisted of 4 to 6 sessions, with follow-up assessments conducted at 1 month and, in studies reporting extended follow-up, at 3 months post-treatment. Data collected included mapping time for coil positioning and setup, incidence of adverse events, and patient-reported outcomes. Subjective measures assessed treatment satisfaction and perceived comfort using questionnaires.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Patients reported high satisfaction with ExoTMS treatment, with improvements observed immediately post-treatment, and further increases at follow-up. Improvements were noted across multiple domains, including overall well-being, mood, perceived stress, and mental energy. Treatment tolerability was high, with 93.3% of participants reporting the therapy as comfortable and associated with minimal to no pain. No serious adverse events were reported.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n ExoTMS appears to be a well-tolerated TMS-based intervention characterized by favorable treatment comfort, minimal pain, and the absence of serious adverse events. Patient-reported outcomes suggest improvements in well-being and self-regulatory domains that persist beyond the immediate treatment period. Compared with conventional TMS systems, ExoTMS may offer practical advantages, including reduced treatment burden and improved clinical workflow efficiency.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpsyt.2026.1850212","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T08:51:41Z","timestamp":1784537501000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Innovations in repetitive transcranial magnetic stimulation: a review of clinical evidence and patient-reported outcomes for ExoTMS"],"prefix":"10.3389","volume":"17","author":[{"given":"David","family":"P\u00e1nek","sequence":"first","affiliation":[{"name":"DP Neuro s.r.o.","place":["Prague, Czechia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V\u00e1clav","family":"Gerla","sequence":"additional","affiliation":[{"name":"Czech Institute of Informatics, Robotics and Cybernetics (CIIRC), Czech Technical 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