Abstract
Introduction: The purpose of this study was to determine the efficacy of right sided low frequency rTMS in Treatment Resistant Anxiety Disorders including but not limited to, Generalized Anxiety Disorder, Social Anxiety & Panic Disorder and Post Traumatic Stress Disorder. Patient selection criteria included any patients between the ages of 18-60, with an Anxiety Disorder as a primary diagnosis and a Generalized Anxiety Disorder – 7 Score of 10 or more. All patients were screened for other differential diagnosis’, evidence based psychotherapy for more than a year, documented trials of 3 or more psychopharmacological agents & had no history of substance abuse which yielded 12 patients that were eligible for this study. All patients underwent 36 rTMS treatments over the course of 9 weeks, with an acute taper at starting week 7. All patients received the 1 Hz, Low frequency protocol, Right Dorsolateral Prefrontal Cortex, 2000 pulses with motor thresholds between 100%-120%. Patients completed GAD-7’s on a biweekly basis with reporting done during the middle of the week. Background: The objective of this study was to measure the outcomes of repetitive Transcranial Magnetic Stimulation (rTMS) for treatment of the Anxiety Based Disorders including GAD, Panic Disorder, & PTSD. Patient demographics both males & females, ages 18-60 years of age, with a mean score of 17.5 on their GAD-7. Methods: All 12 patients underwent 36 rTMS treatments with NeuroStar ™ TMS on the RDLPFC (80%-120% MT, 1 Hz in a sequence of 1 pulse per second for 33:20 minutes providing 2000 inhibitory pulses). Treatment occurred 5 times weekly for 6 weeks with a taper for 3 weeks. Patients would undergo bi-weekly clinical screening via GAD-7 and patient feedback. Results: 100% of participants completed the full course of 36 treatments with an appropriate taper. Patients who received the low frequency right sided TMS treatments had an average of a 14.0 points reduction on their GAD-7 measures, with a mean starting scale of 17.5 and a mean ending scale of 3.5. Conclusions: The results of low frequency right sided TMS for anxiety-based disorders are indicative of a significant clinical response. Low frequency protocols have been found to be mood stabilizing in theory. The GAD-7 scale is explanatory of the sensitivity of such a treatment protocol. Further investigation is warranted. Funding: None Conflicts of Interest: None
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