Transcranial magnetic stimulation in anxiety and trauma‐related disorders: A systematic review and meta‐analysis

Brain and Behavior - Tập 9 Số 6 - 2019
Patricia Cirillo1,2,3, Alexandra K. Gold4,5, Antônio Egídio Nardi3, Ana Claudia Ornelas3, Andrew A. Nierenberg4,1,6, Joan A. Camprodon4,1,2, Gustavo Kinrys4,1,6
1Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
2Division of Neuropsychiatry, Department of Psychiatry, Massachusetts General Hospital, Charlestown, Massachusetts
3Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
4Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Boston, Massachusetts
5Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
6Harvard Medical School, Boston, Massachusetts

Tóm tắt

AbstractBackgroundTranscranial magnetic stimulation (TMS) has been evaluated as an effective treatment option for patients with major depressive disorder. However, there are limited studies that have evaluated the efficacy of TMS for other neuropsychiatric disorders such as anxiety and trauma‐related disorders. We reviewed the literature that has evaluated TMS as a treatment for anxiety and trauma‐related disorders.MethodsWe searched for articles published up to December 2017 in Embase, Medline, and ISI Web of Science databases, following the Preferred Items for Reporting of Systematic Reviews and Meta‐Analyses (PRISMA) statement. Articles (n = 520) evaluating TMS in anxiety and trauma‐related disorders were screened and a small subset of these that met the eligibility criteria (n = 17) were included in the systematic review, of which nine evaluated TMS in posttraumatic stress disorder (PTSD), four in generalized anxiety disorder (GAD), two in specific phobia (SP), and two in panic disorder (PD). The meta‐analysis was performed with PTSD and GAD since PD and SP had an insufficient number of studies and sample sizes.ResultsAmong anxiety and trauma‐related disorders, TMS has been most widely studied as a treatment for PTSD. TMS demonstrated large overall treatment effect for both PTSD (ES = −0.88, 95% CI: −1.42, −0.34) and GAD (ES = −2.06, 95% CI: −2.64, −1.48), including applying high frequency over the right dorsolateral prefrontal cortex. Since few studies have evaluated TMS for SP and PD, few conclusions can be drawn.ConclusionsOur meta‐analysis suggests that TMS may be an effective treatment for GAD and PTSD.

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Brain and Behavior

Tập 9 Số 6

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