Emory University investigators report that two weeks of low-frequency, MRI-guided transcranial magnetic stimulation (TMS) reduced right amygdala reactivity to threat and produced clinically meaningful symptom improvement in adults with post-traumatic stress disorder (PTSD).

The randomized, blinded trial enrolled 50 adults with PTSD symptoms; 47 completed the study. Researchers used MRI scans to personalize the scalp target for each participant and randomly assigned people to active or placebo stimulation. The treatment course lasted two weeks.

Compared with placebo, active TMS reduced right amygdala reactivity. The amygdala is the brain region involved in processing fear. Clinical benefit appeared after the two-week treatment and persisted for at least six months, the full follow-up reported. Seventy-four percent of participants in the active group experienced a clinically meaningful reduction in PTSD symptoms. Participants also reported changes in emotional responses to trauma, including improved management of nightmares.

"This study shows that we can directly target the brain circuits involved in PTSD and produce measurable changes in both brain function and symptoms," said Sanne van Rooij, PhD, associate professor of Psychiatry and Behavioral Sciences at Emory University School of Medicine. The authors describe this as the first study to use MRI to individualize TMS for PTSD.

TMS is an FDA-approved non-invasive brain stimulation treatment for several conditions, including major depression, but is not currently approved for PTSD. The paper appears in The American Journal of Psychiatry. Contributors include researchers from Emory, Harvard Medical School, Wayne State University, Dartmouth College and the National Center for PTSD. Funders listed are the National Institutes of Health and the Brain & Behavior Research Foundation.

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Tags: TMS, PTSD, amygdala, MRI-guided stimulation, clinical trial

Topics: Non-invasive brain stimulation, Neuromodulation, Mental health technology