OBJECTIVE: We aimed to investigate the efficacy of 20 Hz repetitive transcranial magnetic stimulation (rTMS) of either right or left dorsolateral prefrontal cortex (DLPFC) as compared to sham rTMS for the relief of posttraumatic stress disorder (PTSD)-associated symptoms. METHOD: In this double-blind, placebo-controlled phase II trial conducted between October 2005 and July 2008, 30 patients with DSM-IV-diagnosed PTSD were randomly assigned to receive 1 of the following treatments: active 20 Hz rTMS of the right DLPFC, active 20 Hz rTMS of the left DLPFC, orsham rTMS. Treatments were administered in 10 daily sessions over 2 weeks. A blinded rater assessed severity of core PTSD symptoms, depression, and anxiety before, during, and after completion of the treatment protocol. In addition, a battery of neuropsychological tests was measured before and after treatment. RESULTS: Results show that both active conditions-20 Hz rTMS of left and right DLPFC-induced a significant decrease in PTSD symptoms as indexed by the PTSD Checklist and Treatment Outcome PTSD Scale; however, right rTMS induced a larger effect as compared to left rTMS. In addition, there was a significant improvement of mood after left rTMS and a significant reduction of anxiety following right rTMS. Improvements in PTSD symptoms were long lasting; effects were still significant at the 3-month follow-up. Finally, neuropsychological evaluation showed that active 20 Hz rTMS is not associated with cognitive worsening and is safe for use in patients with PTSD. CONCLUSIONS: These results support the notion that modulation of prefrontal cortex can alleviate the core symptoms of PTSD and suggest that high-frequency rTMS of right DLPFC might be the optimal treatment strategy. Copyright 2010 Physicians Postgraduate Press, Inc.
RCT Entities:
OBJECTIVE: We aimed to investigate the efficacy of 20 Hz repetitive transcranial magnetic stimulation (rTMS) of either right or left dorsolateral prefrontal cortex (DLPFC) as compared to sham rTMS for the relief of posttraumatic stress disorder (PTSD)-associated symptoms. METHOD: In this double-blind, placebo-controlled phase II trial conducted between October 2005 and July 2008, 30 patients with DSM-IV-diagnosed PTSD were randomly assigned to receive 1 of the following treatments: active 20 Hz rTMS of the right DLPFC, active 20 Hz rTMS of the left DLPFC, or sham rTMS. Treatments were administered in 10 daily sessions over 2 weeks. A blinded rater assessed severity of core PTSD symptoms, depression, and anxiety before, during, and after completion of the treatment protocol. In addition, a battery of neuropsychological tests was measured before and after treatment. RESULTS: Results show that both active conditions-20 Hz rTMS of left and right DLPFC-induced a significant decrease in PTSD symptoms as indexed by the PTSD Checklist and Treatment Outcome PTSD Scale; however, right rTMS induced a larger effect as compared to left rTMS. In addition, there was a significant improvement of mood after left rTMS and a significant reduction of anxiety following right rTMS. Improvements in PTSD symptoms were long lasting; effects were still significant at the 3-month follow-up. Finally, neuropsychological evaluation showed that active 20 Hz rTMS is not associated with cognitive worsening and is safe for use in patients with PTSD. CONCLUSIONS: These results support the notion that modulation of prefrontal cortex can alleviate the core symptoms of PTSD and suggest that high-frequency rTMS of right DLPFC might be the optimal treatment strategy. Copyright 2010 Physicians Postgraduate Press, Inc.
Authors: S L Rauch; B A van der Kolk; R E Fisler; N M Alpert; S P Orr; C R Savage; A J Fischman; M A Jenike; R K Pitman Journal: Arch Gen Psychiatry Date: 1996-05
Authors: Michael Koenigs; Edward D Huey; Vanessa Raymont; Bobby Cheon; Jeffrey Solomon; Eric M Wassermann; Jordan Grafman Journal: Nat Neurosci Date: 2007-12-23 Impact factor: 24.884
Authors: Gregory A Fonzo; Madeleine S Goodkind; Desmond J Oathes; Yevgeniya V Zaiko; Meredith Harvey; Kathy K Peng; M Elizabeth Weiss; Allison L Thompson; Sanno E Zack; Steven E Lindley; Bruce A Arnow; Booil Jo; James J Gross; Barbara O Rothbaum; Amit Etkin Journal: Am J Psychiatry Date: 2017-07-18 Impact factor: 18.112
Authors: Amit Etkin; Adi Maron-Katz; Wei Wu; Gregory A Fonzo; Julia Huemer; Petra E Vértes; Brian Patenaude; Jonas Richiardi; Madeleine S Goodkind; Corey J Keller; Jaime Ramos-Cejudo; Yevgeniya V Zaiko; Kathy K Peng; Emmanuel Shpigel; Parker Longwell; Russ T Toll; Allison Thompson; Sanno Zack; Bryan Gonzalez; Raleigh Edelstein; Jingyun Chen; Irene Akingbade; Elizabeth Weiss; Roland Hart; Silas Mann; Kathleen Durkin; Steven H Baete; Fernando E Boada; Afia Genfi; Jillian Autea; Jennifer Newman; Desmond J Oathes; Steven E Lindley; Duna Abu-Amara; Bruce A Arnow; Nicolas Crossley; Joachim Hallmayer; Silvia Fossati; Barbara O Rothbaum; Charles R Marmar; Edward T Bullmore; Ruth O'Hara Journal: Sci Transl Med Date: 2019-04-03 Impact factor: 17.956
Authors: Joseph J Taylor; Daniel J Neitzke; George Khouri; Jeffrey J Borckardt; Ron Acierno; Peter W Tuerk; Matthew Schmidt; Mark S George Journal: Psychiatry Res Date: 2014-06-16 Impact factor: 3.222