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Repetitive transcranial magnetic stimulation over the dorsolateral prefrontal cortex for treating posttraumatic stress disorder: an exploratory meta-analysis of randomized, double-blind and sham-controlled trials.

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Repetitive transcranial magnetic stimulation over the dorsolateral prefrontal cortex for treating posttraumatic stress disorder: an exploratory meta-analysis of randomized, double-blind and sham-controlled trials.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Berlim, Marcelo T. Van Den Eynde, Frederique
Description	Author Affiliation: Berlim MT ( Assistant Professor, Department of Psychiatry, McGill University, Montreal, Quebec); Van Den Eynde F ( Assistant Professor, Department of Psychiatry, McGill University, Montreal, Quebec)
Abstract	OBJECTIVE: Repetitive transcranial magnetic stimulation (rTMS) applied to the dorsolateral prefrontal cortex (DLPFC) has yielded promising results as a treatment for posttraumatic stress disorder (PTSD). However, to date, no quantitative review of its clinical utility has been published. METHOD: We searched for randomized and sham-controlled trials from 1995 to March 2013 using MEDLINE, Embase, PsycINFO, CENTRAL, and SCOPUS. We then performed an exploratory random effects meta-analysis. RESULTS: Studies on rTMS applied to the right DLPFC included 64 adults with PTSD. The pooled Hedges g effect size for pre and post changes in clinician-rated and self-reported PTSD symptoms were, respectively, 1.65 (P < 0.001) and 1.91 (P < 0.001), indicating significant and large-sized differences in outcome favouring active rTMS. Also, there were significant pre and post decreases with active rTMS in overall anxiety (Hedges g = 1.24; P = 0.02) and depressive (Hedges g = 0.85; P < 0.001) symptoms. Dropout rates at study end did not differ between active and sham rTMS groups. Regarding rTMS applied to the left DLPFC, there is only one study published to date (using a high frequency protocol), and its results showed that active rTMS seems to be superior overall to sham rTMS. CONCLUSIONS: Our exploratory meta-analysis shows that active rTMS applied to the DLPFC seems to be effective and acceptable for treating PTSD. However, the small number of subjects included in the analyses limits the generalizability of these findings. Future studies should include larger samples and deliver optimized stimulation parameters.
File Format	HTM / HTML
ISSN	07067437
e-ISSN	14970015
Journal	The Canadian Journal of Psychiatry
Issue Number	9
Volume Number	59
Language	English
Publisher	Sage Publications
Publisher Date	2014-09-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Psychiatry Prefrontal Cortex Pathology Stress Disorders, Post-traumatic Transcranial Magnetic Stimulation Patient Acceptance Of Health Care Psychiatric Status Rating Scales Randomized Controlled Trials As Topic Diagnosis Psychology Therapy Meta-analysis
Content Type	Text
Resource Type	Article
Subject	Psychiatry and Mental Health

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