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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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 genera…
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PTSD has most consistently been treated by targeting the right DLPFC, stimulation of which produces large reductions in posttraumatic symptoms together with concurrent improvement in anxiety and depression.
“PtsD, by contrast, has most consistently been treated by targeting the right DlPFc, stimulation of which produces large reductions in posttraumatic symptoms together with concurrent improvement in anxiety and depression”
From Feasibility, tolerability, and preliminary effectiveness of an accelerated bilateral intermittent theta-burst stimulation protocol in adults with posttraumatic stress disorder and comorbid depressive disorder following mild traumatic brain injury (2026) · cites this paper as Berlim & Van den Eynde, 2014
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References 86 · Cited by 96
- Authors
- Berlim, M. T., & Van den Eynde, F.
- Affiliations
- Douglas Mental Health University Institute (CA)
- Assistant Professor, Department of Psychiatry, McGill University, Montreal, Quebec; Co-Director, Neuromodulation Research Clinic, Douglas Mental Health University Institute, Montreal, Quebec
- Corresponding author
- Berlim, Marcelo T
- Venue
- The Canadian Journal of Psychiatry
- Publisher
- SAGE Publications
- Published
- 2014-09
- Volume
- 59
- Issue
- 9
- Pages
- 487-496
- ISSN
- 0706-7437 (ISSN-L)
- 1497-0015
- PMC
- PMC4168811
- OpenAlex
- W1526779747
- Cited by
- 96
- References
- 86
- Citations by year
- 2026: 10 · 2025: 5 · 2024: 9 · 2023: 7 · 2022: 5 · 2021: 9 · 2020: 9 · 2019: 11 · 2018: 7 · 2017: 9 · 2016: 6 · 2015: 9
- FWCI
- 0.65
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Canadian Journal of Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- BrainsWay
- Topics
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Keywords
- repetitive transcranial magnetic stimulation, post-traumatic stress disorder, dorsolateral prefrontal cortex, anxiety symptoms, depressive symptoms, treatment discontinuation, high-frequency stimulation
- MeSH terms
- Adult, Female, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Psychiatric Status Rating Scales, Stress Disorders, Post-Traumatic, Randomized Controlled Trials as Topic, Treatment Outcome, Prefrontal Cortex, Transcranial Magnetic Stimulation
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