Bilateral sequential theta burst stimulation in depressed veterans with service related posttraumatic stress disorder: a feasibility study
Open accessAbstract
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.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Emerging reports support bilateral and accelerated approaches in patients with comorbid depressive and posttraumatic presentations.
“emerging reports support bilateral and accelerated approaches in patients with comorbid depressive and posttraumatic presentations”
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 Vaithianathan et al. 2022
The Discussion reports improvement in depressive and PTSD symptoms after bilateral sequential theta-burst stimulation in eight patients, supporting the bilateral part of the claim. The paper does not report an accelerated treatment approach for patients with both conditions; its Introduction describes shorter iTBS sessions, and its References list an accelerated study in major depression alone. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe protocol was bilateral and accelerated, combining two design features that are individually supported but less commonly reported in combination.
“the protocol was bilateral and accelerated, combining two design features that are individually supported but less commonly reported in combination”
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 Vaithianathan et al. 2022
The Introduction and Methods describe a bilateral protocol, and the Discussion says studies using bilateral TBS were scarce. But the Methods report 19–30 sessions over 4–6 weeks, not an accelerated schedule. The paper therefore does not support the claim that this protocol combined bilateral and accelerated delivery. (LLM, conf=0.90)
Experimental — accuracy not yet measuredThe present estimate (exact 95% CI upper bound 5.6%) is consistent with the broader safety profile of iTBS established in large multicentre trials including THREE-D, and with emerging bilateral accelerated reports in trauma-related populations.
“the present estimate (exact 95% ci upper bound 5.6%) is consistent with the broader safety profile of itBs established in large multicentre trials including thRee-D (Blumberger et al. 2018), and with emerging bilateral accelerated reports in trauma-related populations (chang et al. 2023;Vaithianathan et al. 2022).”
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 Vaithianathan et al. 2022
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The PHQ-9: Validity of a brief depression severity measure
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2001.016009606.x · Cited by 44,910 · see citing works
An efficient and accurate new method for locating the F3 position for prefrontal TMS applications
Beam, W., Borckardt, J. J., Reeves, S. T., & George, M. S. (2009) · Brain Stimulation · doi:10.1016/j.brs.2008.09.006 · Cited by 626 · see citing works
Leucht, S., Fennema, H., Engel, R., Kaspers–Janssen, M., Lepping, P., & Szegedi, A. (2013) · Journal of Affective Disorders · doi:10.1016/j.jad.2012.12.001 · Cited by 211 · see citing works
Theta-Burst Transcranial Magnetic Stimulation for Posttraumatic Stress Disorder
Philip, N. S., Barredo, J., Aiken, E., Larson, V., Jones, R. N., Shea, M. T., Greenberg, B. D., & van ’t Wout-Frank, M. (2019) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2019.18101160 · Cited by 183 · see citing works
Baeken, C., De Raedt, R., Van Schuerbeek, P., Vanderhasselt, M. A., De Mey, J., Bossuyt, A., & Luypaert, R. (2010) · Behavioural Brain Research · doi:10.1016/j.bbr.2010.06.029 · Cited by 101 · see citing works
Trevizol, A. P., Goldberger, K. W., Mulsant, B. H., Rajji, T. K., Downar, J., Daskalakis, Z. J., & Blumberger, D. M. (2019) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.5091 · Cited by 70 · cited 2× · see citing works
“While this still needs to be clarified further given the heterogeneity of studies, rTMS studies utilizing right inhibitory stimulation followed by left excitatory stimulation have shown to be effective in TRD [9, 10, 13, 14].”
Background
Flagged first, then by citations
Research works printed but not linked: 17
- [1]Breslau N The epidemiology of posttraumatic stress disorder: what is the extent of the problem? J Clinical Psychiatry 2021 62 Suppl 17 16 22 11495091
- [2]Astill Wright L Sijbrandij M Sinnerton R Lewis C Roberts NP Bisson JI Pharmacological prevention and early treatment of post-traumatic stress disorder and acute stress disorder: a systematic review and meta-analysis Transl Psychiatry 2019 9 1 334 10.1038/s41398-019-0673-5 31819037 PMC6901463 · DOI
- [3]Cirillo P Gold AK Nardi AE Ornelas AC Nierenberg AA Camprodon J & Kinrys G.Transcranial magnetic stimulation in anxiety and trauma-related disorders: A systematic review and meta-analysis Brain Behaviour 2019 9 6 e01284 PMC6576151 31066227
- [4]Blumberger DM Vila-Rodriguez F Thorpe KE Feffer K Noda Y Giacobbe P Effectiveness of theta burst versus high-frequency repetitive transcranial magnetic stimulation in patients with depression (THREE-D): a randomised non-inferiority trial Lancet (London, England) 2018 391 10131 1683 1692 10.1016/S0140-6736(18)30295-2 29726344 · DOI · Paper page
- [6]Nursey J Sbisa A Knight H Ralph N Cowlishaw S Forbes D Exploring Theta Burst Stimulation for Post-traumatic Stress Disorder in Australian Veterans-A Pilot Study Military Medicine 2020 185 9-10 e1770 e1778 10.1093/milmed/usaa149 32601710 · DOI
- [7]Philip NS Doherty RA Faucher C Aiken E van’t Wout-Frank M Transcranial Magnetic Stimulation for Posttraumatic Stress Disorder and Major Depression: Comparing Commonly Used Clinical Protocols J Traumatic Stress 2021 0 1 8 PMC8581062 33973681
- [8]Kan RL, Zhang BB, Zhang JJ, Kranz GS. Non-invasive brain stimulation for posttraumatic stress disorder: a systematic review and meta-analysis. Translational Psychiatry. 2020;10(1):1-2. PMC7256039 32467579
- [9]Berlim MT Van den Eynde F Daskalakis ZJ A systematic review and meta-analysis on the efficacy and acceptability of bilateral repetitive transcranial magnetic stimulation (rTMS) for treating major depression Psychol Med 2013 43 11 2245 54 10.1017/S0033291712002802 23200131 · DOI
- [10]Berlim M Van den Eynde F Daskalakis ZJ Clinically Meaningful Efficacy and Acceptability of Low-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) for Treating Primary Major Depression: A Meta-Analysis of Randomized, Double-Blind and Sham-Controlled Trials Neuropsychopharmacol 2013 38 543 551 10.1038/npp.2012.237 PMC3572468 23249815 · DOI
- [11]Palmiero M Piccardi L Frontal EEG asymmetry of mood: A mini-review Front Behav Neurosci 2017 6 224 10.3389/fnbeh.2017.00224 PMC5701669 29209180 · DOI
- [12]Bruder GE Stewart JW McGrath PJ Right brain, left brain in depressive disorders: clinical and theoretical implications of behavioral, electrophysiological and neuroimaging findings Neurosci Biobehavioral Reviews 2017 1 178 91 10.1016/j.neubiorev.2017.04.021 28445740 · DOI
- [13]Blumberger DM Maller JJ Thomson L Mulsant BH Rajji TK Maher M Brown PE Downar J Vila-Rodriguez F Fitzgerald PB Daskalakis ZJ Unilateral and bilateral MRI-targeted repetitive transcranial magnetic stimulation for treatment-resistant depression: a randomized controlled study J Psychiatry Neurosci 2016 41 4 E58 10.1503/jpn.150265 27269205 PMC4915938 · DOI · Paper page
- [15]Plewnia C Pasqualetti P Große S Schlipf S Wasserka B Zwissler B Treatment of major depression with bilateral theta burst stimulation: a randomized controlled pilot trial J Affect Disord 2014 156 219 23 10.1016/j.jad.2013.12.025 24411682 · DOI
- [16]Burhan AM Patience JA Teselink J Marlatt NM Babapoor-Farrokhran S Palaniyappan L Bilateral sequential theta burst stimulation for multiple-therapy-resistant depression: A naturalistic observation study J Psychiatric Res 2020 130 342 346 10.1016/j.jpsychires.2020.08.009 32882575 · DOI
- [18]Duprat R Desmyter S Rudi D van Heeringen K Van den Abbeele D Tandt H Accelerated intermittent theta burst stimulation treatment in medication-resistant major depression: A fast road to remission? J Affective Disorders 2016 200 6 14 10.1016/j.jad.2016.04.015 27107779 · DOI · Paper page
- [22]Spitzer RL Kroenke K Williams JBW Lowe B A brief measure for assessing generalized anxiety disorder: the GAD-7 Arch Intern Med 2006 166 10 1092 1097 10.1001/archinte.166.10.1092 16717171 · DOI · Paper page
- [24]McGirr A, Devoe DJ, Raedler A, Debert CT, Ismail Z, Berlim MT. Repetitive Transcranial Magnetic Stimulation for the Treatment of Post-traumatic Stress Disorder: A Systematic Review and Network Meta-analysis: La Stimulation Magnétique Transcrânienne Répétitive Pour le Traitement du Trouble de Stress Post-Traumatique: Une Revue Systématique et une Méta-Analyse en Réseau. Can J Psychiatry. 2021;66(9):763–73. 10.1177/0706743720982432. Epub 2020 Dec 23. PMC8504289 33355483 · DOI
Cited by
Sorted by citations
Chang, C.-H., Liu, C.-Y., Chen, S.-J., & Tsai, H.-C. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1061088 · Cited by 5 · see citing works
Rubaye, S., Shah, A., Aldulaimy, W., Hernandez, A., Park, H., Sorial, V., Prasad, P., & Iyengar, S. (2026) · International Journal of Psychiatry in Clinical Practice · doi:10.1080/13651501.2026.2733584
- Authors
- Vaithianathan, T., Blair, M., Soares, V., Rybak, Y. E., Palaniyappan, L., Richardson, J. D., & Burhan, A. M.
- Affiliations
- Ontario Shores Centre for Mental Health Sciences (CA)
- Lawson Health Research Institute (CA)
- Western University (CA)
- Corresponding author
- Burhan, Amer M.
- Venue
- BMC Psychiatry
- Published
- 2022-02-03
- Volume
- 22
- Issue
- 1
- Pages
- 81-81
- ISSN
- 1471-244X (ISSN-L)
- PMC
- PMC8811967
- OpenAlex
- W4210724345
- Cited by
- 11
- References
- 6
- Citations by year
- 2026: 4 · 2025: 1 · 2024: 5 · 2023: 1
- FWCI
- 0.61
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- TSpace (University of Toronto) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Scholarship@Western (Western University) (submittedVersion)
- Topics
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- repetitive transcranial magnetic stimulation, treatment-resistant depression, post-traumatic stress disorder, military veterans, treatment safety and feasibility
- MeSH terms
- Feasibility Studies, Humans, Stress Disorders, Post-Traumatic, Veterans, Transcranial Magnetic Stimulation, Depressive Disorder, Treatment-Resistant
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
