A variant of transcranial magnetic stimulation (TMS), intermittent theta-burst stimulation (iTBS), has come up as an effective treatment solution for helping manage and reduce symptoms of post-traumatic stress disorder (PTSD), revealed a recent study published in the American Journal of Psychiatry.
Lead author Dr. Noah Philip, an associate professor of psychiatry and human behavior at the Alpert Medical School at Brown University, said that according to the findings, the new forms of transcranial magnetic stimulation could reduce symptoms of PTSD and depression, as well as improve occupational and social function among patients.
The study results showed that within the first week of treatment, patients observed significant clinical benefits. The researchers also observed that the patients reported relief in PTSD symptoms with continued exposure.
Latest breakthrough in PTSD treatment
The researchers arbitrarily selected 50 patients between the age of 18 and 70 years diagnosed with PTSD whom had previously received PTSD treatment with medication or psychotherapy for 6 weeks or longer but were still experiencing symptoms. They were made to undergo 10 days of active or sham iTBS and were provided the option of attending 10 further unblinded sessions.
The data was collected at two intervals: once after 2 weeks and once after a month. The results were as follows:
- After 2 weeks, the group of participants which received active iTBS showed substantial progress in educational and social functions and minor improvement in depression as compared to those who received sham stimulation. The improvements in educational and social functions enhanced with increased exposure whereas the improvement in depression could be maintained with minimal alterations to the treatment.
- After a month, those participants who underwent active iTBS and also unblinded sessions showed superior results in management of PTSD symptoms, depression, and occupational and social functions as compared to those who underwent sham stimulation.
It was also noted that at baseline, 90 percent of the participants were diagnosed with co-occurring depression and 50 percent were diagnosed with a comorbid substance use disorder (SUD). The study was well tolerated with only 3 participants withdrawing.
Treatment outcome could be predicted
Dr. Philip said that fMRI could be used to predict which patients with PTSD would respond positively to iTBS. Signs of improvement were noted within a week of active stimulation and continued to improve over time. Those participants who received active stimulation and also continued treatment after the initial two weeks showed superior results. Nearly 81 percent of those who received active stimulation achieved a 12-point reduction in CAPS rating as compared to 67 percent of those who received sham stimulation.
Dr. F. Andrew Kozel, director at the TMS Clinic and staff psychiatrist in mental health and behavioral sciences at the James A. Haley Veterans Administration Hospital and Clinics, said that even though psychotherapy and medications proved to be effective for some patients, the study suggested that other treatment options were equally important and were much needed. He added that further studies would help in establishing iTBS as a clinically effective treatment.
What is TBS
Theta-burst stimulation (TBS) is a novel transcranial magnetic stimulation (TMS) procedure which prompted synaptic plasticity using short bursts of high frequency stimulation (50-Hz) repeated at 5-Hz intervals. Dr. Philip said that noninvasive brain stimulation was the latest evidence backed treatment which supported TMS for PTSD and depression.
iTBS, a second generation TMS, can be administered either continually or intermittently. Unlike prior TMS treatment for PTSD, which lasted for nearly 36 weeks, iTBS was a rapid, easy to operate alternative which could be combined with psychotherapy, thus providing wider access to treatment. One iTBS session lasted anywhere between 35 minutes to an hour.
The most common side effects experienced by the participants were headaches and discomfort at the site of treatment. Treatment site discomfort was experienced more frequently by those who received active stimulation compared to the sham stimulation group. However, there were no major significant adverse effects. One participant from the sham stimulation group developed suicidal ideation during the follow up while one participant from the same group developed homicidal ideation.
Post-traumatic stress disorder (PTSD) is a devastating mental health disorder triggered by horrific and disturbing events either experienced or witnessed by the patient. Most people who experience fear overcome it naturally, however patients suffering from PTSD continue feeling endangered and scared even when they are not in danger.
There is no specific time period as to when a patient will start experiencing PTSD post the traumatic event. Some common symptoms include nightmares, flashbacks, and severe anxiety. PTSD may last for years affecting the individual’s day to day functioning. However, it can be overcome with timely treatment from credible mental health facilities in California.
If you or a loved one is battling PTSD and is looking for California mental health services, contact the California Mental Health Helpline. Call at our 24/7 helpline number (855) 559-3923 to know more about state-of-the-art, yet affordable mental health centers in California and other states. Our representatives can connect you with the desired facility and guide you through the admission process. You can even chat online for further assistance.