Neuroimaging-guided intermittent theta Burst stimulation for the treatment of post-traumatic stress disorder: a randomized controlled trial
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Citation
Abstract
Post-traumatic stress disorder (PTSD) is a highly debilitating mental illness that is incited by various types of trauma and causes core symptoms of re-experiencing, hyperarousal, avoidance of trauma-related stimuli, and negative cognition and mood.
It is accompanied by functional, social, and occupational impairment, as well as higher risks of medical comorbidities and mortality. Estimates indicate that PTSD affects 3.9% of the global population, and 7-9% of the US population, with only 50% of those with persistent PTSD treatment-seeking. The gold standard of PTSD treatment is prolonged exposure therapy and cognitive processing theory, with the addition of antidepressants; however, dropout rates are high likely due to the adverse effects of worsening re-experiencing of trauma and exacerbating behaviors of avoidance. As a result, alternative therapies such as transcranial magnetic stimulation (TMS) represent more tolerable treatment options. Historically, literature on TMS is promising for its low risk of side effects and efficacy, but there is no general consensus on treatment-specific targets, frequency of treatment delivery, or long-term efficacy. This proposed study will evaluate the use of neuroimaging guided intermittent theta burst stimulation, a form of TMS, for core PTSD symptom reduction and its efficacy up to one year in duration to potentially reduce the morbidity and mortality sequelae of PTSD.