Repetitive transcranial magnetic stimulation in complex posttraumatic stress disorder: A case report

Abstract

Abstract Complex posttraumatic stress disorder (cPTSD) represents a unique clinical phenomenon. It is marked by traditional PTSD symptoms coupled with emotional instability, unfavorable self-perception, and challenges in interpersonal relationships. While the diagnostic recognition of cPTSD remains debated, emerging evidence supports its unique profile and clinical significance. This study presents an instance involving a 30-year-old woman who has been clinically determined to have severe cPTSD, comorbid borderline personality traits, major depressive disorder, and fibromyalgia. The patient underwent 25 bilateral sessions of repetitive transcranial magnetic stimulation (rTMS) targeting prefrontal cortices. Comprehensive assessments using standardized scales were conducted pre- and post-rTMS treatment. Results revealed significant reductions in cPTSD symptoms (PTSD Checklist-5 scores decreased from 55 to 21) and reduced borderline personality symptomatology (the Zanarini Rating Scale for borderline personality disorder scores decreased from 9 to 4), alongside improvements in other areas. These findings suggest the potential utility of rTMS as an adjunctive intervention for cPTSD. Aligned with previous PTSD research, the study highlights the capacity of rTMS to mitigate cPTSD symptoms, comorbidities, and subjective distress. Nevertheless, further exploration with larger samples and extended follow-up is needed to substantiate and generalize these findings. This preliminary evidence underscores rTMS’s promise as a prospective therapeutic avenue for complex PTSD, offering hope for improved treatment strategies.