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Br J Psychiatry. 2016 Sep;209(3):222-8. doi: 10.1192/bjp.bp.115.168203. Epub 2016 May 19.

Repetitive transcranial magnetic stimulation for generalised anxiety disorder: a pilot randomised, double-blind, sham-controlled trial.

Author information

1
Gretchen J. Diefenbach, PhD, Anxiety Disorders Center, The Institute of Living, Hartford and Yale University School of Medicine, New Haven, Connecticut; Laura B. Bragdon, MA, Binghamton University, Binghamton, New York; Luis Zertuche, BSc, Christopher J. Hyatt, PhD, Olin Neuropsychiatry Research Center, The Institute of Living, Hartford, Connecticut; Lauren S. Hallion, PhD, Anxiety Disorders Center, The Institute of Living, Hartford, Connecticut; David F. Tolin, PhD, Anxiety Disorders Center, The Institute of Living, Hartford and Yale University School of Medicine, New Haven, Connecticut; John W. Goethe, MD, Burlingame Center for Research and Education, The Institute of Living, Hartford, Connecticut; Michal Assaf, MD, Olin Neuropsychiatry Research Center, The Institute of Living, Hartford and Yale University School of Medicine, New Haven, Connecticut, USA Gretchen.Diefenbach@hhchealth.org.
2
Gretchen J. Diefenbach, PhD, Anxiety Disorders Center, The Institute of Living, Hartford and Yale University School of Medicine, New Haven, Connecticut; Laura B. Bragdon, MA, Binghamton University, Binghamton, New York; Luis Zertuche, BSc, Christopher J. Hyatt, PhD, Olin Neuropsychiatry Research Center, The Institute of Living, Hartford, Connecticut; Lauren S. Hallion, PhD, Anxiety Disorders Center, The Institute of Living, Hartford, Connecticut; David F. Tolin, PhD, Anxiety Disorders Center, The Institute of Living, Hartford and Yale University School of Medicine, New Haven, Connecticut; John W. Goethe, MD, Burlingame Center for Research and Education, The Institute of Living, Hartford, Connecticut; Michal Assaf, MD, Olin Neuropsychiatry Research Center, The Institute of Living, Hartford and Yale University School of Medicine, New Haven, Connecticut, USA.

Abstract

BACKGROUND:

Repetitive transcranial magnetic stimulation (rTMS) holds promise for treating generalised anxiety disorder (GAD) but has only been studied in uncontrolled research.

AIMS:

This is the first randomised controlled trial (clinicaltrials.gov: NCT01659736) to investigate the efficacy and neural correlates of rTMS in GAD.

METHOD:

Twenty five participants (active n = 13; sham, n = 12) enrolled. rTMS was targeted at the right dorsolateral prefrontal cortex (DLPFC, 1 Hz, 90% resting motor threshold).

RESULTS:

Response and remission rates were higher in the active v. sham groups and there were significant group × time interactions for anxiety, worry and depressive symptoms, favouring active v. sham. In addition, right DLPFC activation during a decision-making gambling task increased at post-treatment for active rTMS only, and changes in neuroactivation correlated significantly with changes in worry symptoms.

CONCLUSIONS:

Findings provide preliminary evidence that rTMS may improve GAD symptoms in association with modifying neural activity in the stimulation site.

PMID:
27198484
DOI:
10.1192/bjp.bp.115.168203
[Indexed for MEDLINE]

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