From the Research
Effectiveness of TMS for Comorbid MDD and PTSD
- Studies have shown that Transcranial Magnetic Stimulation (TMS) can be an effective treatment for patients with comorbid Major Depressive Disorder (MDD) and Post-Traumatic Stress Disorder (PTSD) 1, 2, 3.
- A 2018 study found that 5 Hz repetitive TMS significantly reduced symptoms of both PTSD and MDD in patients with comorbid disorders, with 48.6% of patients meeting the criteria for PTSD response and 42.9% demonstrating categorical response for MDD 1.
- Another study in 2022 compared the effectiveness of 5 Hz TMS and intermittent theta burst stimulation (iTBS) for treating comorbid PTSD and MDD, and found that 5 Hz TMS demonstrated superior symptom improvement for both disorders 2.
Predictors of Response to TMS
- Research has identified several predictors of response to TMS in patients with comorbid MDD and PTSD, including functional connectivity of the medial prefrontal cortex and subgenual anterior cingulate cortex 4.
- A 2019 study found that white matter integrity, particularly in the anterior thalamic radiations, was associated with symptom improvement in PTSD and MDD after TMS 4.
- Machine learning analysis of resting-state electroencephalography (EEG) has also been shown to predict clinical response to TMS in patients with comorbid MDD and PTSD, with high specificity for non-response 5.
Limitations and Future Directions
- While the existing evidence suggests that TMS can be an effective treatment for comorbid MDD and PTSD, further research is needed to fully understand the mechanisms of action and to optimize treatment parameters 1, 2, 4.
- Studies have noted limitations such as small sample sizes, lack of sham conditions, and variability in TMS protocols, highlighting the need for larger, controlled trials to confirm the efficacy of TMS for comorbid MDD and PTSD 1, 2, 5.