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. 2009 Jan;23(1):54-9.
doi: 10.1016/j.janxdis.2008.03.015. Epub 2008 Mar 28.

Repetitive TMS combined with exposure therapy for PTSD: a preliminary study

Elizabeth A Osuch  1 , Brenda E Benson, David A Luckenbaugh, Marilla Geraci, Robert M Post, Una McCann
Affiliations

Repetitive TMS combined with exposure therapy for PTSD: a preliminary study

Elizabeth A Osuch et al. J Anxiety Disord. 2009 Jan.

Abstract

Treatment for anxiety and post-traumatic stress disorder (PTSD) includes exposure therapy and medications, but some patients are refractory. Few studies of repetitive transcranial magnetic stimulation (rTMS) for anxiety or PTSD exist. In this preliminary report, rTMS was combined with exposure therapy for PTSD. Nine subjects with chronic, treatment-refractory PTSD were studied in a placebo-controlled, crossover design of imaginal exposure therapy with rTMS (1Hz) versus sham. PTSD symptoms, serum and 24h urine were obtained and analyzed. Effect sizes for PTSD symptoms were determined using Cohen's d. Active rTMS showed a larger effect size of improvement for hyperarousal symptoms compared to sham; 24-h urinary norepinephrine and serum T4 increased; serum prolactin decreased. Active rTMS with exposure may have symptomatic and physiological effects. Larger studies are needed to confirm these preliminary findings and verify whether rTMS plus exposure therapy has a role in the treatment of PTSD.

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