Kozel, F., Motes, M., Didehbani, N., DeLaRosa, B., Bass, C., Schraufnagel, C., Jones, P., Morgan, C., Spence, J., Kraut, M. and Hart, J. (2018). Repetitive TMS to augment cognitive processing therapy in combat veterans of recent conflicts with PTSD: A randomized clinical trial. Journal of Affective Disorders, 229, 506-514.
This randomized, double-blind, sham-controlled study investigated whether low frequency (1Hz) rTMS over the right DLPFC in combination with Cognitive Processing Therapy (CPT) is more effective in reducing PTSD symptoms than sham stimulation plus CPT. War veterans with current PTSD (n = 103) received active rTMS or sham immediately before 60 minutes of CPT for 12 daily sessions. The main outcome measures were the Clinician Administered PTSD Scale (CAPS) and the PTSD Checklist (PCL). These were completed at baseline, session 5, session 9, and follow-ups at 1, 3, and 6 months. Both rTMS + CPT and sham + CPT showed significant improvements on both measures at all time points compared to baseline. However, active rTMS + CPT showed significantly greater PCL score improvements compared to sham + CPT at all time points. Further, for CAPS scores active rTMS + CPT showed significantly greater improvements versus sham + CPT at session 5, plus follow-up at 3 and 6 months. The authors suggested active rTMS may augment the benefits of therapy through improving fronto-limbic connectivity, which may reduce amygdala hyperactivity related to PTSD. They suggest more research is required to examine protocol-therapy timings, number of sessions, and the effectiveness of rTMS with other forms of therapy.
*For original abstract/publication see the link below.