Objective:

To examine the technological characteristics, safety profile, and therapeutic implications of ExoTMS, focusing on patient-reported outcomes, treatment comfort, and safety.

Approach:

• Study Inclusion: Eight studies were included, involving 182 active-treated participants receiving stimulation at effective intensity levels.
• Treatment Protocols: Participants underwent 4 to 6 sessions, with follow-up assessments at 1 month and, where applicable, at 3 months post-treatment.
• Data Collection: Data included mapping time for coil positioning, incidence of adverse events, and patient-reported outcomes on treatment satisfaction and perceived comfort.

Key Findings:

• Patients reported high satisfaction with ExoTMS treatment, with improvements observed immediately post-treatment and at follow-up.
• Improvements were noted across multiple domains, including overall well-being, mood, perceived stress, and mental energy.
• 93.3% of participants reported the therapy as comfortable with minimal to no pain.
• No serious adverse events were reported.

Interpretation:

ExoTMS is a well-tolerated intervention with favorable treatment comfort and safety, suggesting potential advantages over conventional TMS systems.

Limitations:

• The review is based on a limited number of studies and participants.
• Long-term effects beyond 3 months were not assessed.

Conclusion:

ExoTMS may offer practical advantages, including reduced treatment burden and improved clinical workflow efficiency.