Journal: Brain Stimulation (2018)
Authors: E Sisko, A Tendler, M DeLuca, R Gersner, S Garrison, H Mayfield, D Mages, J Sutton, N Rodriguez
Background:
PTSD patients have hypo-activity in the mPFC during traumatic recall. Stimulating the mPFC with dTMS after an individualized traumatic script was effective in decreasing PTSD symptoms in a double blinded placebo-controlled study.
Objective:
A retrospective case series treating patients with PTSD comorbid with severe depression who were ineligible for a double blinded controlled PTSD study.
Methods:
Fourteen patients with moderate to severe PTSD were administered dTMS with the H7 coil over the dmPFC 3-5 times week. Treatment occurred after a brief provocation with an individualized script on their most distressing traumatic event. dTMS was administered at 100%MT of the foot, 18Hz, 2 second trains, 20 second intervals for 2880 total pulses. Patient measures at baseline, weekly, and endpoint were the PTSD checklist list (PCL) or modified PTSD symptom scale (MPSS). PCL or MPSS response was defined as 30% change and partial response defined as 20% change. Clinicians gave the Global Inventory-Severity (CGI-S) score at baseline and endpoint. Response was defined as a 2-point decrease and remission was a CGI-S of a 1 or 2.
Results:
Patients’ age ranged from 22 to 71 with a mean of 49. Of the 14 patients, 11 responded, 13 partially responded, and 1 failed to respond on their patient rating scales. By CGI-S, of the 14 patients, 12 responded, 7 remitted, and 2 failed to respond. According to CGI-S and PCL/MPSS, all patients significantly improved; patients who received over 20 treatments improved significantly better.
Conclusions:
H7 coil dTMS in a naturalistic setting appears efficacious for PTSD.
Full Publication: Deep TMS for PTSD with the H7 coil in a naturalistic setting: Case series – Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation
