Rewiring canine anxiety: The impact of accelerated HF-rTMS on brain perfusion and behavioral outcomes in dogs

Canine anxiety disorders significantly affect both pet dogs and their owners, highlighting the need for effective treatment approaches. Given the promising effects of accelerated repetitive transcranial magnetic stimulation (arTMS) in human medicine, this study explores its effects as a potential intervention for canine anxiety disorders. In this open-label trial, 20 dogs diagnosed with an anxiety disorder underwent two accelerated high-frequency rTMS (aHF-rTMS) treatment courses targeting the left frontal cortex, administered one month apart. Behavioral assessments were conducted using the Canine Behavioral Assessment and Research Questionnaire (C-BARQ) at baseline and at multiple follow-up time points, while single photon emission computed tomography (SPECT) was used to measure regional cerebral blood flow (rCBF). Following the second aHF-rTMS treatment course, significant reductions in social and nonsocial fear were detected, compared to baseline. In total, 56 % of the dogs were classified as responders, achieving a ≥ 20 % reduction in C-BARQ scores. SPECT imaging revealed progressive rCBF increases in the left frontal and subcortical regions in all dogs, while cerebellar perfusion changes were specific to responders only. No baseline factors reliably predicted treatment response. These findings suggest that aHF-rTMS can modulate brain perfusion and improve anxiety-related behaviors in dogs, positioning it as a promising therapeutic tool in veterinary behavioral medicine, while further bolstering the canine brain as a valid translational animal model for human noninvasive brain stimulation research.