School of Psychological Sciences, Australian College of Applied Psychology, Sydney, Australia; Australian Defence Force, Joint Health Unit - Central Australia.
School of Psychological Sciences, Australian College of Applied Psychology, Melbourne, Australia.
J Affect Disord. 2021 Jun 15;289:55-65. doi: 10.1016/j.jad.2021.04.003. Epub 2021 Apr 14.
Posttraumatic stress disorder (PTSD) is a pervasive mental health condition with limited treatment success. Transcranial magnetic stimulation (TMS) has shown positive outcomes for people with PTSD, using different treatment protocols. This meta-analysis sought to examine which variables in TMS treatment are associated with treatment benefits.
A literature search of major online research databases from inception to September 15, 2020 was conducted to identify primary research studies using TMS to treat PTSD. Treatment effect data and TMS treatment variables were coded and analysed using a random effects model. Meta-regression and analyses of moderating variables were conducted to ascertain which variables were associated with significant treatment effects.
An overall effect size of d = 1.17, 95% CI [0.89 - 1.45] for TMS as a treatment for PTSD was found. Analysis of moderators showed that there was a significantly larger treatment effect for high frequency TMS (d = 1.44) compared with low frequency (d = 0.72), p = .006; there was no significant difference between TMS targeting the left dorsolateral prefrontal cortex (DLPFC) and the right DLPFC; and larger treatment doses were not associated with stronger treatment effects.
Not all published studies were available in English or reported the necessary data to be included in this meta-analysis.
TMS shows potential as a treatment for PTSD, although further research is required to understand the neurological mechanisms of TMS on specific PTSD symptoms so that more effective treatment can be designed for individuals.
创伤后应激障碍（PTSD）是一种普遍存在的心理健康问题，治疗成功率有限。经颅磁刺激（TMS）已显示出对 PTSD 患者的积极效果，使用不同的治疗方案。这项荟萃分析旨在研究 TMS 治疗中的哪些变量与治疗效果相关。
从研究开始到 2020 年 9 月 15 日，对主要在线研究数据库进行了文献检索，以确定使用 TMS 治疗 PTSD 的原始研究。使用随机效应模型对治疗效果数据和 TMS 治疗变量进行编码和分析。进行元回归和调节变量分析，以确定哪些变量与显著的治疗效果相关。
TMS 治疗 PTSD 的总体效应大小为 d=1.17，95%CI[0.89-1.45]。调节变量分析表明，高频 TMS（d=1.44）的治疗效果明显大于低频 TMS（d=0.72），p=0.006；TMS 针对左背外侧前额叶皮层（DLPFC）和右 DLPFC 的效果没有显著差异；更大的治疗剂量与更强的治疗效果无关。
并非所有已发表的研究都可用英文获得，或报告了纳入本荟萃分析所需的数据。
TMS 显示出作为 PTSD 治疗方法的潜力，但需要进一步研究以了解 TMS 对特定 PTSD 症状的神经机制，以便为个体设计更有效的治疗方法。
