Transcranial Magnetic Stimulation for Posttraumatic Stress Disorder and Generalized Anxiety Disorder

Posttraumatic stress disorder (PTSD) and generalized anxiety disorder (GAD) are debilitating psychiatric disorders. While treatments are often effective, many patients do not adequately respond or experience significant side effects. Transcranial magnetic stimulation (TMS) is an emerging approach for treating PTSD and GAD. Several randomized clinical trials have demonstrated that TMS over the dorsolateral prefrontal cortex may be efficacious in reducing psychiatric symptoms; however, results are inconsistent regarding whether any parameter or treatment paradigm is superior. Other RCTs have targeted novel brain regions using newer TMS modalities. Combining TMS with psychotherapy may augment response in patients with PTSD, yet results are inconclusive. Little research has been done on TMS in combination with psychotherapy for GAD, indicating a need for further investigation. Future studies may assess TMS parameter optimization for enhancing effectiveness and improving therapeutic response duration. Identifying response biomarkers through functional magnetic resonance imaging and electroencephalography may offer a means to predict and monitor clinical response as precision methods to improve treatment response.