Accelerated theta-burst transcranial magnetic stimulation of the bilateral dorsolateral prefrontal cortex in a patient with post-traumatic stress disorder and major depressive disorder: Case report

Chun-Hung Chang; Chieh-Yu Liu; Shaw-Ji Chen; Hsin-Chi Tsai

doi:10.3389/fpsyt.2023.1061088

Accelerated theta-burst transcranial magnetic stimulation of the bilateral dorsolateral prefrontal cortex in a patient with post-traumatic stress disorder and major depressive disorder: Case report

Front Psychiatry. 2023 Feb 2:14:1061088. doi: 10.3389/fpsyt.2023.1061088. eCollection 2023.

Authors

Chun-Hung Chang^{1

2

3}, Chieh-Yu Liu⁴, Shaw-Ji Chen^{5

6}, Hsin-Chi Tsai^{7

8}

Affiliations

¹ Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.
² Department of Psychiatry and Brain Disease Research Center, China Medical University Hospital, Taichung, Taiwan.
³ An Nan Hospital, China Medical University, Tainan, Taiwan.
⁴ Biostatistical Consulting Laboratory, Department of Speech Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
⁵ Department of Psychiatry, Taitung MacKay Memorial Hospital, Taitung, Taiwan.
⁶ Department of Medicine, Mackay Medical College, New Taipei, Taiwan.
⁷ Department of Psychiatry, Tzu-Chi General Hospital, Hualien, Taiwan.
⁸ Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan.

Abstract

Background: Theta-burst transcranial magnetic stimulation has demonstrated promising effectiveness as treatment for post-traumatic stress disorder (PTSD) and depression. However, the effect of accelerated theta-burst stimulation (TBS) in comorbid with PTSD and depression remains unknown.

Case presentation: We report a case of a 25-year-old woman with PTSD and depression whose symptoms markedly improved after continuous TBS of the right dorsolateral prefrontal cortex (DLPFC) and intermittent TBS (iTBS) over the left DLPFC, and then with 20 min break before the 2nd iTBS session.

Conclusions: Accelerated TBS over the bilateral DLPFC may improve severe PTSD and depression. Accelerated TBS may have more improvement of depression symptoms than PTSD symptoms. Further trials are warranted to investigate the effect and safety for patients with complicated PTSD and depression.

Keywords: depression; dorsolateral prefrontal cortex; post-traumatic stress disorder; theta-burst stimulation; transcranial magnetic stimulation.

Publication types

Case Reports

Grants and funding

This work was supported by grants from An Nan Hospital, China Medical University Hospital (ANHRF110-24 and ANHRF111-25).