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One-year clinical outcomes following theta burst stimulation for post-traumatic stress disorder

Theta burst transcranial magnetic stimulation (TBS) is a potential new treatment for post-traumatic stress disorder (PTSD). We previously reported active intermittent TBS (iTBS) was associated with superior clinical outcomes for up to 1-month, in a sample of fifty veterans with PTSD, using a crossov...

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Autores principales: Petrosino, Nicholas J., Wout-Frank, Mascha van ’t, Aiken, Emily, Swearingen, Hannah R., Barredo, Jennifer, Zandvakili, Amin, Philip, Noah S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7162862/
https://www.ncbi.nlm.nih.gov/pubmed/31794974
http://dx.doi.org/10.1038/s41386-019-0584-4
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author Petrosino, Nicholas J.
Wout-Frank, Mascha van ’t
Aiken, Emily
Swearingen, Hannah R.
Barredo, Jennifer
Zandvakili, Amin
Philip, Noah S.
author_facet Petrosino, Nicholas J.
Wout-Frank, Mascha van ’t
Aiken, Emily
Swearingen, Hannah R.
Barredo, Jennifer
Zandvakili, Amin
Philip, Noah S.
author_sort Petrosino, Nicholas J.
collection PubMed
description Theta burst transcranial magnetic stimulation (TBS) is a potential new treatment for post-traumatic stress disorder (PTSD). We previously reported active intermittent TBS (iTBS) was associated with superior clinical outcomes for up to 1-month, in a sample of fifty veterans with PTSD, using a crossover design. In that study, participants randomized to the active group received a total of 4-weeks of active iTBS, or 2-weeks if randomized to sham. Results were superior with greater exposure to active iTBS, which raised the question of whether observed effects persisted over the longer-term. This study reviewed naturalistic outcomes up to 1-year from study endpoint, to test the hypothesis that greater exposure to active iTBS would be associated with superior outcomes. The primary outcome measure was clinical relapse, defined as any serious adverse event (e.g., suicide, psychiatric hospitalization, etc.,) or need for retreatment with repetitive transcranial magnetic stimulation (rTMS). Forty-six (92%) of the initial study’s intent-to-treat participants were included. Mean age was 51.0 ± 12.3 years and seven (15.2%) were female. The group originally randomized to active iTBS (4-weeks active iTBS) demonstrated superior outcomes at one year compared to those originally randomized to sham (2-weeks active iTBS); log-rank ChiSq = 5.871, df = 1, p = 0.015; OR = 3.50, 95% CI = 1.04–11.79. Mean days to relapse were 296.0 ± 22.1 in the 4-week group, and 182.0 ± 31.9 in the 2-week group. When used, rTMS retreatment was generally effective. Exploratory neuroimaging revealed default mode network connectivity was predictive of 1-year outcomes (corrected p < 0.05). In summary, greater accumulated exposure to active iTBS demonstrated clinically meaningful improvements in the year following stimulation, and default mode connectivity could be used to predict longer-term outcomes.
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spelling pubmed-71628622020-04-22 One-year clinical outcomes following theta burst stimulation for post-traumatic stress disorder Petrosino, Nicholas J. Wout-Frank, Mascha van ’t Aiken, Emily Swearingen, Hannah R. Barredo, Jennifer Zandvakili, Amin Philip, Noah S. Neuropsychopharmacology Article Theta burst transcranial magnetic stimulation (TBS) is a potential new treatment for post-traumatic stress disorder (PTSD). We previously reported active intermittent TBS (iTBS) was associated with superior clinical outcomes for up to 1-month, in a sample of fifty veterans with PTSD, using a crossover design. In that study, participants randomized to the active group received a total of 4-weeks of active iTBS, or 2-weeks if randomized to sham. Results were superior with greater exposure to active iTBS, which raised the question of whether observed effects persisted over the longer-term. This study reviewed naturalistic outcomes up to 1-year from study endpoint, to test the hypothesis that greater exposure to active iTBS would be associated with superior outcomes. The primary outcome measure was clinical relapse, defined as any serious adverse event (e.g., suicide, psychiatric hospitalization, etc.,) or need for retreatment with repetitive transcranial magnetic stimulation (rTMS). Forty-six (92%) of the initial study’s intent-to-treat participants were included. Mean age was 51.0 ± 12.3 years and seven (15.2%) were female. The group originally randomized to active iTBS (4-weeks active iTBS) demonstrated superior outcomes at one year compared to those originally randomized to sham (2-weeks active iTBS); log-rank ChiSq = 5.871, df = 1, p = 0.015; OR = 3.50, 95% CI = 1.04–11.79. Mean days to relapse were 296.0 ± 22.1 in the 4-week group, and 182.0 ± 31.9 in the 2-week group. When used, rTMS retreatment was generally effective. Exploratory neuroimaging revealed default mode network connectivity was predictive of 1-year outcomes (corrected p < 0.05). In summary, greater accumulated exposure to active iTBS demonstrated clinically meaningful improvements in the year following stimulation, and default mode connectivity could be used to predict longer-term outcomes. Springer International Publishing 2019-12-03 2020-05 /pmc/articles/PMC7162862/ /pubmed/31794974 http://dx.doi.org/10.1038/s41386-019-0584-4 Text en © This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply. This article is published with open access 2019 Open Access 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/.
spellingShingle Article
Petrosino, Nicholas J.
Wout-Frank, Mascha van ’t
Aiken, Emily
Swearingen, Hannah R.
Barredo, Jennifer
Zandvakili, Amin
Philip, Noah S.
One-year clinical outcomes following theta burst stimulation for post-traumatic stress disorder
title One-year clinical outcomes following theta burst stimulation for post-traumatic stress disorder
title_full One-year clinical outcomes following theta burst stimulation for post-traumatic stress disorder
title_fullStr One-year clinical outcomes following theta burst stimulation for post-traumatic stress disorder
title_full_unstemmed One-year clinical outcomes following theta burst stimulation for post-traumatic stress disorder
title_short One-year clinical outcomes following theta burst stimulation for post-traumatic stress disorder
title_sort one-year clinical outcomes following theta burst stimulation for post-traumatic stress disorder
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7162862/
https://www.ncbi.nlm.nih.gov/pubmed/31794974
http://dx.doi.org/10.1038/s41386-019-0584-4
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