Post-traumatic stress disorder (PTSD) is a prevalent and debilitating illness. While standard treatment with pharmacotherapy and psychotherapy may be effective, approximately 20 to 30% of patients remain symptomatic. These individuals experience depression, anxiety, and elevated rates of suicide. For treatment-resistant patients, there is a growing interest in the use of neuromodulation therapies, including transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), and deep brain stimulation (DBS). We conducted a systematic review on the use of neuromodulation strategies for PTSD and pooled 13 randomized clinical trials (RCTs), 11 case series, and 6 case reports for analysis. Overall, most studies reported favorable outcomes in alleviating both PTSD and depressive symptoms. Although several RCTs described significant differences when active and sham stimulations were compared, others found marginal or nonsignificant differences between groups. Also positive were studies comparing PTSD symptoms before and after treatment. The side effect profile with all 3 modalities was found to be low, with mostly mild adverse events being reported. Despite these encouraging data, several aspects remain unknown. Given that PTSD is a highly heterogeneous condition that can be accompanied by distinct psychiatric diagnoses, defining a unique treatment for this patient population can be quite challenging. There has also been considerable variation across trials regarding stimulation parameters, symptomatic response, and the role of adjunctive psychotherapy. Future studies are needed to address these issues.

创伤后应激障碍（PTSD）是一种普遍存在且使人衰弱的疾病。虽然药物治疗和心理治疗的标准治疗可能有效，但大约 20% 至 30% 的患者仍然有症状。这些人会经历抑郁、焦虑和自杀率升高。对于难治性患者，人们对使用神经调节疗法越来越感兴趣，包括经颅磁刺激（TMS）、经颅直流电刺激（tDCS）和深部脑刺激（DBS）。我们对神经调节策略在 PTSD 中的应用进行了系统评价，并汇总了 13 项随机临床试验 (RCT)、11 个病例系列和 6 个病例报告进行分析。总体而言，大多数研究报告在减轻创伤后应激障碍和抑郁症状方面取得了良好的结果。尽管一些随机对照试验描述了比较主动刺激和假刺激时的显着差异，但其他随机对照试验发现组间存在边际或不显着的差异。比较治疗前后 PTSD 症状的研究也很积极。发现所有 3 种治疗方式的副作用都很低，所报告的不良事件大多是轻微的。尽管有这些令人鼓舞的数据，但有几个方面仍然未知。鉴于 PTSD 是一种高度异质性的病症，可能伴有不同的精神科诊断，因此为该患者群体确定独特的治疗方法可能相当具有挑战性。关于刺激参数、症状反应和辅助心理治疗的作用，各试验之间也存在相当大的差异。需要未来的研究来解决这些问题。