High Frequency Left-Sided Repetitive Transcranial Magnetic Stimulation (rTMS) for Post Traumatic Stress Disorder With...

Area of Science:

• Neuroscience
• Psychiatry
• Clinical Medicine

Background:

• Repetitive transcranial magnetic stimulation (rTMS) is a recognized treatment for co-occurring post-traumatic stress disorder (PTSD) and major depressive disorder (MDD).
• Current rTMS protocols lack standardization, particularly for military personnel and first responders with comorbid PTSD and MDD.

Purpose of the Study:

• To describe the outcomes of high-frequency rTMS applied to the left dorsolateral prefrontal cortex (DLPFC) in inpatients with comorbid PTSD and MDD.
• To evaluate the efficacy and tolerability of this specific rTMS protocol.

Main Methods:

• Retrospective review of patient files for adult inpatients receiving ≥10 rTMS treatments between 01/01/2017 and 01/12/2024.
• Paired t-tests were used to analyze changes in symptom scores (MADRS, PCL-5, HoNOS, MoCA).

Main Results:

• High-frequency left DLPFC rTMS was administered to 89.8% of patients (n=106).
• Left-sided rTMS was associated with significantly improved MADRS, PCL-5, HoNOS, and MoCA scores.
• Patients receiving left-sided rTMS had fewer treatments and shorter admission lengths, though nearly half required readmission.

Conclusions:

• High-frequency left-sided rTMS is generally well-tolerated for comorbid PTSD and MDD.
• This treatment demonstrates potential for reducing both depressive and PTSD symptoms.
• Further research into rTMS subtypes is needed to standardize care and develop optimal treatment guidelines.