Bilateral Sequential Theta Burst Stimulation in Depressed Veterans With Service Related Post Traumatic Stress Disorder: A Feasibility Study

SOURCE: BMC Psychiatry. 22(1):81, 2022 02 03.

AUTHORS: Vaithianathan T; Blair M; Soares V; Rybak YE; Palaniyappan L; Richardson JD; Burhan AM

BACKGROUND: Depression comorbid with posttraumatic stress disorder (PTSD) can be disabling and treatment resistant. Preliminary evidence suggests that repetitive transcranial magnetic stimulation (rTMS), may have a role in helping these patients. There are only few published studies using different rTMS paradigms including bilateral intermittent theta burst (iTBS) and low frequency rTMS.

METHODS: In this small cohort observation study, we examined the efficacy of bilateral sequential theta-burst stimulation (bsTBS) in 8 treatment resistant depression (TRD) military veterans with PTSD comorbidity stemming from military service experience.

RESULTS: bsTBS was generally well tolerated and resulted in 25% and 38% remission and response rates on Depression scores respectively; 25% remission and response rate on PTSD scores.

DISCUSSION: This study demonstrates preliminary feasibility and safety of bsTBS in TRD with comorbid military service related PTSD. We concluded that this paradigm might hold promise as a therapeutic tool to help patients with TRD co-morbid with military service related PTSD. Further adequately powered studies to compare rTMS treatment paradigms in this patient group are warranted.