Theta-burst transcranial magnetic stimulation for posttraumatic stress disorder
American Journal of Psychiatry Jun 27, 2019
Philip NS, et al. - Given that for posttraumatic stress disorder (PTSD), transcranial magnetic stimulation (TMS) is a novel approach and intermittent theta-burst stimulation (iTBS) is a new, more rapid administration protocol with data supporting effectiveness in depression, researchers carried out a sham-controlled study of iTBS for PTSD. Ten days of sham-controlled iTBS (1,800 pulses/day) was provided to 50 veterans with PTSD, followed by 10 unblinded sessions. They noted high retention with side effects consistent with standard TMS; blinding was successful. Active iTBS was considered superior on clinician- and self-rated PTSD symptoms, depression, and social and occupational function, as per one-month outcomes. Stronger (greater positive) connectivity within the default mode network and anticorrelated (greater negative) cross-network connectivity in neuroimaging was significantly predictive of clinical improvement. Findings support iTBS as a promising new treatment for PTSD. Given the early occurrence of most clinical improvements from stimulation, further investigation of optimal iTBS time course and duration is required.
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