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Title: | Non-invasive brain stimulation for posttraumatic stress disorder : a systematic review and meta-analysis | Authors: | Kan, RLD Zhang, BBB Zhang, JJQ Kranz, GS |
Issue Date: | 2020 | Source: | Translational psychiatry, 2020, v. 10, no. 1, 168 | Abstract: | Approximately 7–9% of people develop posttraumatic stress disorder in their lifetime, but standard pharmacological treatment or psychotherapy shows a considerable individual variation in their effectiveness. Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) hold promise for the treatment of posttraumatic stress disorder. The objective of this meta-analysis was to summarize the existing evidence on the therapeutic effects of these brain stimulation treatments on posttraumatic core symptoms. We systematically retrieved articles published between 1st January 2000 and 1st January 2020 comparing the effects of active with sham stimulation or no intervention in posttraumatic patients from eight databases. Random-effects model was used for meta-analysis. Meta-regression and subgroup meta-analysis was performed to investigate the influence of stimulation dose and different stimulation protocols, respectively. 20 studies were included in this review, where of 11 randomized controlled trials were subjected to quantitative analysis. Active stimulation demonstrated significant reductions of core posttraumatic symptoms with a large effect size (Hedge’s g = −0.975). Subgroup analysis showed that both excitatory and inhibitory rTMS of the right dorsolateral prefrontal cortex led to symptom reductions with a large (Hedges’ g = −1.161, 95% CI, −1.823 to −0.499; p = 0.015) and medium effect size (Hedges’ g = −0.680, 95% CI: −0.139 to −0.322; p ≤ 0.001) respectively. Results further indicated significant durability of symptom-reducing effects of treatments during a two to four weeks period post stimulation (Hedges’ g = −0.909, 95% CI: −1.611 to −0.207; p = 0.011). rTMS of the right dorsolateral prefrontal cortex appears to have a positive effect in reducing core symptoms in patients with posttraumatic stress disorder. | Publisher: | Nature Publishing Group | Journal: | Translational psychiatry | EISSN: | 2158-3188 | DOI: | 10.1038/s41398-020-0851-5 | Rights: | © The Author(s) 2020. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. The following publication Kan, R.L.D., Zhang, B.B.B., Zhang, J.J.Q. et al. Non-invasive brain stimulation for posttraumatic stress disorder: a systematic review and meta-analysis. Transl Psychiatry 10, 168 (2020), is available at https://doi.org/10.1038/s41398-020-0851-5 |
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