title: Different frequency repetitive transcranial magnetic stimulation (rTMS) for posttraumatic stress disorder (PTSD): A systematic review and meta-analysis.
abstract: Posttraumatic stress disorder (PTSD) is a psychiatric disorder. Repetitive transcranial magnetic stimulation (rTMS) has been found to be effective for treating PTSD, but whether different frequencies have different effects remains controversial. We conducted this systematic review and meta-analysis to address this question. We searched the literature for studies written in English or Chinese in 9 electronic databases from the databases' inception to August 1, 2016. Additional articles were identified from the reference lists of identified studies and from personal reference collections. Eighteen articles were included, and 11 were suitable for the meta-analysis (Combined sample size was 377 (217 in active rTMS groups, 160 in sham-controlled groups)). Low-frequency (LF) rTMS resulted in a significant reduction in the PTSD total score and the depression score (1. PTSD total score: pooled SMD, 0.92; CI, 0.11-1.72; 2. Depression: pooled SMD, 0.54; CI, 0.08-1.00). High-frequency (HF) rTMS showed the following results: 1. PTSD total score: pooled SMD, 3.24; CI, 2.24-4.25; 2. re-experiencing: pooled SMD, -1.77; CI, -2.49-(-1.04); 3. Avoidance: pooled SMD, -1.57; CI, -2.50-(-0.84); 4. hyperarousal: pooled SMD, -1.32; CI, -2.17-(-0.47); 5. depression: pooled SMD, 1.92; CI, 0.80-3.03; and 6. Anxiety: pooled SMD, 2.67; CI, 1.82-3.52. Therefore, both HF and LF rTMS can alleviate PTSD symptoms. Although the evidence is extremely limited, LF rTMS can reduce overall PTSD and depression symptoms. HF rTMS can improve the main and related symptoms of PTSD. However, additional research is needed to substantiate these findings.
authors.affiliation: Department of Disaster Medical Science, Sichuan University, Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu, 610041, PR China. Electronic address: tingting.yan84@qq.com.
authors.forename: Tingting
authors.initials: T
authors.lastname: Yan
authors.affiliation: Department of Psychiatry, West China Hospital, Sichuan University, Chengdu, 610041, PR China.
authors.forename: Qinglian
authors.initials: Q
authors.lastname: Xie
authors.affiliation: Department of Neurobiological Examine Centre, West China Hospital, Sichuan University, Chengdu, 610041, PR China.
authors.forename: Zhong
authors.initials: Z
authors.lastname: Zheng
authors.affiliation: Department of Neurobiological Examine Centre, West China Hospital, Sichuan University, Chengdu, 610041, PR China.
authors.forename: Ke
authors.initials: K
authors.lastname: Zou
authors.affiliation: Department of Neurology, Sichuan Academy of Medical Sciences & Sichuan Provincial Peoples Hospital, Chengdu, 610041, PR China.
authors.forename: Lijuan
authors.initials: L
authors.lastname: Wang
mesh_terms: D055592:Biophysical Phenomena; D001703:Biophysics; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D006801:Humans; D013313:Stress Disorders, Post-Traumatic / Q000503:physiopathology / Q000628:therapy*; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome
keywords: Frequency; Meta-analysis; Posttraumatic stress disorder; Repetitive transcranial magnetic stimulation; Systematic review