Evidence map›Paper›PMID 41241259›Full record

ArticleBrain stimulation

Effectiveness of transcranial magnetic stimulation for posttraumatic stress disorder: A multisite, propensity-matched cohort study of treatment parameters.

Yosef A Berlow, Samantha L Cilli, F Andrew Kozel, Amin Zandvakili, Noelle Marcotullio, Camila Cosmo, Miriam A Goldberg, Bo Dehm Wicklund, Michelle R Madore, Noah S Philip

Abstract readMulticenter Study
In one paragraph

Article in Brain stimulation. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Yosef A BerlowCenter for Neurorestoration and Neurotechnology, VA Providence Healthcare System, Providence, RI, USA; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.
Samantha L CilliCenter for Neurorestoration and Neurotechnology, VA Providence Healthcare System, Providence, RI, USA.
F Andrew KozelDepartment of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Florida State University, Tallahassee, FL, 32306, USA.
Amin ZandvakiliCenter for Neurorestoration and Neurotechnology, VA Providence Healthcare System, Providence, RI, USA; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.
Noelle MarcotullioCenter for Neurorestoration and Neurotechnology, VA Providence Healthcare System, Providence, RI, USA.
Camila CosmoCenter for Neurorestoration and Neurotechnology, VA Providence Healthcare System, Providence, RI, USA; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.
Miriam A GoldbergCenter for Neurorestoration and Neurotechnology, VA Providence Healthcare System, Providence, RI, USA; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.
Bo Dehm WicklundMental Illness Research, Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, 94304, USA.
Michelle R MadoreMental Illness Research, Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, 94304, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, 94305, USA.
Noah S PhilipCenter for Neurorestoration and Neurotechnology, VA Providence Healthcare System, Providence, RI, USA; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA. Electronic address: Noah_Philip@Brown.edu.

Funding

Promoting Research Training During Psychiatry ResidencyR25MH101076 · NIMH · BROWN UNIVERSITY · PI AUDREY TYRKA · 2013 to 2026
$2.8M
CSRD VA IK2 CX002115CSRD VA IK2 CX002603NIMH NIH HHS R25 MH101076RRD VA I50 RX002864
6 · The paper itself

Abstract

backgroundTranscranial magnetic stimulation (TMS) is increasingly used off-label for posttraumatic stress disorder (PTSD), often applying protocols developed for depression. While prior studies suggest high-frequency TMS can improve PTSD symptoms, few have been adequately powered to compare protocols. We examined whether three common TMS protocols yield equivalent outcomes for PTSD in a large, multisite cohort of veterans.

methodsClinical outcomes were analyzed from 756 veterans with comorbid PTSD and depression treated with antidepressant TMS across multiple VA sites. Protocols included left prefrontal 10 Hz TMS (n = 526), left prefrontal intermittent theta burst TMS (iTBS; n = 71), and deep TMS (dTMS; n = 61). PTSD symptoms were measured with the PTSD symptom checklist for DSM-5 (PCL-5). Primary outcomes included PTSD response (>10-point reduction) and remission (PCL-5 <33). Propensity score matching adjusted for baseline differences. Equivalence was set at 10 % for categorical outcomes and Cohen's d = 0.25 for continuous outcomes. Depression outcomes were also analyzed.

resultsAll three TMS protocols produced substantial PTSD symptom reductions (18-22 points). PTSD response rates were 63 % (10 Hz), 65 % (iTBS), and 78 % (dTMS); remission rates were 47 %, 48 %, and 49 %, respectively. Both iTBS and dTMS were noninferior to 10 Hz (all ps < 0.05). Depression outcomes demonstrated similar patterns. DISCUSSION: In this large multisite cohort study of veterans with PTSD and depression, 10 Hz, iTBS, and dTMS protocols demonstrated comparable clinical effectiveness. Limitations are those inherent to cohort studies of veterans. These findings support the effectiveness of TMS for PTSD, and protocol selection based on patient-specific or logistical considerations rather than efficacy differences.

Indexed as

Stress Disorders, Post-TraumaticTranscranial Magnetic StimulationAdultAgedCohort StudiesFemaleHumansMaleMiddle AgedPropensity ScoreTreatment OutcomeVeteransPosttraumatic stress disorderTranscranial magnetic stimulation

Identifiers

PMID41241259
PMCPMC12930423

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.