An open label pilot trial of sequential bifrontal low frequency r-TMS in the treatment of primary insomnia

This pilot study examines the therapeutic effects of bifrontal low frequency (LF) TMS on primary insomnia. In this prospective, open-label study 20 patients with primary insomnia and without major depressive disorder received 15 sequential bifrontal LF rTMS stimulation sessions. By week 3, PSQI scores declined from baseline score of 12.57(sd 2.74) to 9.50 (sd 4.27), a large effects size (0.80 (CI 0.29, 1.36)), and CGI-I scores improved for 52.6% of participants. Results of this pilot indicate that the novel bifrontal LF rTMS benefitted this group of patients suffering from primary insomnia, with absence of sham control a significant study limitation.