Open AccessA Secondary Analysis on Effects of Theta Burst Transcranial Magnetic Stimulation to Reduce Anger in Veterans With Posttraumatic Stress Disorder
Author(s) -
van 't WoutFrank Mascha,
Shea Mary Tracie,
Sorensen David O.,
Faucher Christiana R.,
Greenberg Benjamin D.,
Philip Noah S.
Publication year - 2021
Publication title -
neuromodulation: technology at the neural interface
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.296
H-Index - 60
eISSN - 1525-1403
pISSN - 1094-7159
DOI - 10.1111/ner.13256
Subject(s) - anger , psychology , randomized controlled trial , transcranial magnetic stimulation , depression (economics) , stimulation , psychiatry , physical therapy , medicine , economics , macroeconomics , neuroscience
Anger is an important clinical feature of posttraumatic stress disorder (PTSD) that can hamper recovery. We recently reported that intermittent theta burst stimulation (iTBS) demonstrated preliminary efficacy to reduce symptoms of posttraumatic stress disorder and major depression; here, we performed a secondary analysis testing whether iTBS reduced symptoms of anger over the course of iTBS treatment and compared to sham stimulation. Materials and Methods Fifty veterans with chronic PTSD received ten daily sessions of sham‐controlled, double‐blind iTBS (1800 pulses/session, once per weekday) targeting the right dorsolateral prefrontal cortex (intent‐to‐treat = 25 per group). Participants who completed the double‐blind phase were offered another ten sessions of unblinded iTBS. Participants completed the Dimensions of Anger Reactions scale at pre‐iTBS baseline, treatment midpoints, and endpoints of the blinded and unblinded phases, and at one‐month after the last stimulation session. Correlations between anger, PTSD, depression, and sleep were also explored. Results After the first week, during the double‐blind phase, participants randomized to active stimulation reported significantly reduced anger compared to sham stimulation ( p = 0.04). Participants initially randomized to sham appeared to catch‐up to the point they no longer differed from those initially randomized to active iTBS when they received iTBS during the unblinded phase ( p = 0.14). Anger reduction was maintained at one‐month after iTBS in participants initially randomized to active stimulation (i.e., total of four weeks of iTBS). Conclusions This secondary analysis suggests that iTBS might reduce anger in veterans with PTSD. Future studies focused on more granular level anger outcomes and effects of number of stimulation sessions are needed.