Background

Posttraumatic stress disorder (PTSD) is a pervasive mental health condition with limited treatment success. Transcranial magnetic stimulation (TMS) has shown positive outcomes for people with PTSD, using different treatment protocols. This meta-analysis sought to examine which variables in TMS treatment are associated with treatment benefits.

Methods

A literature search of major online research databases from inception to September 15, 2020 was conducted to identify primary research studies using TMS to treat PTSD. Treatment effect data and TMS treatment variables were coded and analysed using a random effects model. Meta-regression and analyses of moderating variables were conducted to ascertain which variables were associated with significant treatment effects.

Results

An overall effect size of d = 1.17, 95% CI [0.89 – 1.45] for TMS as a treatment for PTSD was found. Analysis of moderators showed that there was a significantly larger treatment effect for high frequency TMS (d = 1.44) compared with low frequency (d = 0.72), p = .006; there was no significant difference between TMS targeting the left dorsolateral prefrontal cortex (DLPFC) and the right DLPFC; and larger treatment doses were not associated with stronger treatment effects.

Limitations

Not all published studies were available in English or reported the necessary data to be included in this meta-analysis.

Conclusions

TMS shows potential as a treatment for PTSD, although further research is required to understand the neurological mechanisms of TMS on specific PTSD symptoms so that more effective treatment can be designed for individuals.

中文翻译：

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经颅磁刺激治疗创伤后应激障碍的荟萃分析

背景

创伤后应激障碍（PTSD）是一种普遍的心理健康状况，治疗成功率有限。使用不同的治疗方案，经颅磁刺激（TMS）对PTSD患者显示出积极的疗效。这项荟萃分析试图检查TMS治疗中哪些变量与治疗获益相关。

方法

从开始到2020年9月15日，对主要的在线研究数据库进行了文献检索，以鉴定使用TMS治疗PTSD的基础研究。使用随机效应模型对治疗效果数据和TMS治疗变量进行编码和分析。进行了Meta回归和中度变量的分析，以确定哪些变量与显着的治疗效果相关。

结果

总体效果大小为d  = 1.17，TMS作为PTSD的治疗占95％CI [0.89 – 1.45]。主持人的分析表明， 与低频（d  = 0.72）相比，高频TMS（d = 1.44）的治疗效果显着更大，p  = .006；而低频（d = 0.72）。针对左背外侧前额叶皮层（DLPFC）和右DLPFC的TMS之间没有显着差异；并且更大的治疗剂量与更强的治疗效果无关。

局限性

并非所有已发表的研究都提供英文版本或报告了必要的数据以纳入该荟萃分析。

结论

尽管需要进一步研究以了解TMS对特定PTSD症状的神经机制，但TMS仍具有治疗PTSD的潜力，因此可以针对个人设计更有效的治疗方法。