TITLE
One Hertz versus Ten Hertz Repetitive TMS Treatment of PTSD

SOURCE
Psychiatry Research. 273:153-162, 2019 03.

AUTHORS
Kozel FA; Van Trees K; Larson V; Phillips S; Hashimie J; Gadbois B; Johnson S; Gallinati J; Barrett B; Toyinbo P; Weisman M; Centorino M; Gibson CA; Catalano G.

ABSTRACT
The purpose of this trial was to test whether right prefrontal cortex 1Hz versus 10Hz rTMS provides a significantly greater improvement in PTSD symptoms and/or function. Veterans 18 to 50 years of age suffering from PTSD were randomized to right prefrontal 1Hz rTMS [2400 pulses/session] versus right prefrontal 10Hz rTMS [2400 pulses/session]. The treatments were performed 5 days a week for 6 weeks with a 3-week taper using the NeuroStar system. There were one month and three months post treatment follow-up evaluations. Forty-four participants were enrolled with 17 being randomized to 1Hz rTMS and 18 to 10Hz rTMS. Both groups had significant improvement in PTSD and depression scores from baseline to the end of acute treatment. The 10Hz group but not the 1Hz group demonstrated significant improvement in function. Although both groups demonstrated significant improvement in PTSD and depression symptoms, a significant advantage for either the 1Hz or 10Hz frequency group on any of the scales acquired was not demonstrated. Further work is required with larger samples sizes to test whether low or high frequency is superior or if individual differences would indicate the more effective frequency.