Evaluating the effectiveness of Theta Burst Stimulation (TBS) as a treatment for Posttraumatic Stress Disorder (PTSD) in an Australian veteran Population – a pilot study

Abstract

Background: Posttraumatic stress disorder (PTSD) is a common and serious mental health problem that can have a profound impact on the person’s functioning and quality of life. Although we have effective treatments for PTSD, there are still many veterans who do not benefit from these approaches; thus, new and innovative treatments are required. Previous research has shown that people with PTSD may have an imbalance in the excitability, or ‘activity levels’, of networks of cells in the brain. Theta Burst Stimulation (TBS) involves the application of magnetic pulses to the scalp to try and change the activity level of the targeted  neural networks in the brain. This study is an uncontrolled pilot case series which aims to assess the impact of Theta Burst Stimulation (TBS) treatment on cognitive and mental health outcomes in veterans with PTSD.

Method: Participants are 15 ex-serving members of the ADF (18 years or older, both males and females) who have a DSM-5 diagnosis of PTSD assessed using CAPS. Participants will receive active treatment with TBS, every day (Monday to Friday) for four weeks. TBS will be provided as 3-pulse 50 Hz bursts applied bilaterally, right then left, at 5 Hz. It will involve a 2 second train of TBS followed by an 8 second rest and will run for a total of 190 seconds. Thus, each treatment takes a little over three minutes. The treatment intensity for TBS will be 120% of resting motor threshold, which is measured by administering single pulse TMS to the muscle area of the brain. Participants will be assessed on cognitive and mental health outcomes at: (a) pre-treatment, (b) post-treatment, and (c) three months follow-up.

Results: Changes in scores on repeated continuous measures will be compared across assessment time points using the Wilcoxon signed-rank test. This study will also examine clinically reliable change using the ClinTools software.

Trial web page: https://www.phoenixaustralia.org/expertise/research/current-treatment-trials/tms/

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