EEG-Spectra-Guided Personalized rTMS in PTSD with Co-occurring Psychiatric Disorders: A Case Series

Abstract

Personalized repetitive Transcranial Magnetic Stimulation (PrTMS^®) offers an individualized approach to neuromodulation through customized treatment protocols. This case series aims to explore therapeutic outcomes of PrTMS^® in two patients with post-traumatic stress disorder (PTSD), based on standardized rating scale scores and spectral EEG-guided alpha brainwave activity optimization. Participants diagnosed with PTSD received PrTMS^® treatments informed by quantitative rating scales and weekly spectral EEG measurements. Weekly psychometric assessments showed an improvement in symptoms, as quantified by PCL-5 (Posttraumatic Stress Disorder Checklist for DSM-5), GAD-7 (Generalized Anxiety Disorder 7-item scale), PHQ-9 (Patient Health Questionnaire-9), and SCI (Sleep Condition Indicator) questionnaires. Specifically, PCL-5 scores demonstrated an average reduction of 20.5 points by the midpoint of treatment (4 weeks), while GAD-7 and PHQ-9 scores decreased by 7 and 8.5 points, respectively, at the end of 7 weeks. Mean SCI scores increased by 6 points by the end of the 7 week-treatment period. While previous studies have also highlighted the role of spectral EEG-directed personalized PrTMS in the treatment of PTSD, ongoing research is needed in order to understand the long-term efficacy of PrTMS^®.

Keywords: Alpha Brainwave Activity; Neuromodulation; PCL-5 (Post-Traumatic Stress Disorder Symptom Severity Checklist for DSM-5); PTSD (Post-Traumatic Stress Disorder); Personalized Repetitive Transcranial Magnetic Stimulation (PrTMS®); Repetitive Transcranial Magnetic Stimulation (rTMS); Spectral EEG; Spectral Electroencephalogram.

Figure 1:

PrTMS^® Treatment Locations.

Figure 2:

PCL-5 Scores of Patient 1.

Figure 3:

PCL-5 Scores of Patient 2.