EEG-Spectra-Guided Personalized rTMS in PTSD with Co-occurring Psychiatric Disorders: A Case Series.

Personalized repetitive Transcranial Magnetic Stimulation (PrTMS) offers an individualized approach to neuromodulation through customized treatment protocols. This case series aims to explore therapeutic outcomes of PrTMS in two patients with post-traumatic stress disorder (PTSD), based on standardized rating scale scores and spectral EEG-guided alpha brainwave activity optimization. Participants diagnosed with PTSD received PrTMS treatments informed by quantitative rating scales and weekly spectral EEG measurements. Weekly psychometric assessments showed an improvement in symptoms, as quantified by PCL-5 (Posttraumatic Stress Disorder Checklist for DSM-5), GAD-7 (Generalized Anxiety Disorder 7-item scale), PHQ-9 (Patient Health Questionnaire-9), and SCI (Sleep Condition Indicator) questionnaires. Specifically, PCL-5 scores demonstrated an average reduction of 20.5 points by the midpoint of treatment (4 weeks), while GAD-7 and PHQ-9 scores decreased by 7 and 8.5 points, respectively, at the end of 7 weeks. Mean SCI scores increased by 6 points by the end of the 7 week-treatment period. While previous studies have also highlighted the role of spectral EEG-directed personalized PrTMS in the treatment of PTSD, ongoing research is needed in order to understand the long-term efficacy of PrTMS.