Table 2.
Therapeutic use of TMS in Generalized Anxiety Disorder
| Study | Double‐blind (Y/N) | Randomized (Y/N) | Age (mean, years) | Active sample (n) | Sham sample (n) | Number of sessions | Target | Frequency | MT (%) | Total pulses | Drop outs (n due to AE) | Results | Follow‐up | Target identification method | Coil | ||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Active group | Sham | Response | Remission | ||||||||||||||
| Diefenbach et al. (2016) | Y | Y | ≥18 (44) |
13
(9 completers) |
12
(10 completers) |
30 | Right DLPFC | 1 Hz | 90% RMT | 27,000 | 4 | 2 |
Active: 7/9 (77.8%)
Sham: 2/10 (20%) p = 0.012 |
Active: 3/9 (33.3%)
Sham: 1/10 (10%) p = 0.213 |
3 months
Remission Active: 6/9 (66.7%) Sham: 0/10 Response Active: 7/9 (10%) |
MNI coordinates |
Sham: Neuronetics XPLOR
Active: not reported |
| Dilkov et al. (2017) | Y | Y | 23–57 (active: 34 ± 7/ sham: 38 ± 10) |
25
(15 completers) |
25
(25 completers) |
20 (acute) + 5 (taper down) | Right DLPFC | 20 Hz | 110% RMT | 90,000 | 10 (0) | 0 |
Active group: 15/15 (100%)
Sham: 3/25 (12%) |
Active: 12/15 (80%) | 1‐month follow‐up: active‐group remission = 15/15 (100%) | 5 cm rule |
Active: Figure of 8
Sham: 90o from skull |
| White and Tavakoli (2015) | N | N | Mean: 42.46 | 13 GAD + MDD | 24–36 | Right + left DLPFC | 1 Hz + 10 Hz | Not reported |
rDLPFC: 24,000–36,000
lDLPFC: not reported |
0 | All responders also remitted |
GAD ‐ 11/13 (84.6%)
MDD – 10/13 (76.9%) |
No | not reported | Not reported | ||
| Bystritsky et al. (2008, 2009) | N | N | 18–56 (45.30 ± 12.1) | 10 | 6 (twice/week, for 3 weeks) | Right DLPFC | 1 Hz | 90% RMT | 5,400 | 0 |
8/10 (80%)
Mean scores significantly decreased HAM‐A (p = 0.001) HAM‐D (p = 0.001) FDADS anxiety subscale (p = 0.000) |
6/10 (60%) |
6‐months (Bystritsky et al., 2008): sustained improvement.
No significant difference to the end of rTMS treatment. |
Activation across all task periods x resting state | Figure of 8 | ||
DLPFC = dorsolateral prefrontal cortex; FDADS = Four‐dimensional anxiety and depression scale; GAD = generalized anxiety disorder; HAM‐A = Hamilton anxiety rating scale; HAM‐D = Hamilton depression rating scale; MDD = major depressive disorder; MT = motor threshold; N = no; RMT = resting motor threshold; rTMS = repetitive transcranial magnetic stimulation; Y = yes.