Table 1.
Study characteristics of included studies.
| Study | Study design | Subjects | Group location | Stimulation type | Target | Total dose | Intensity | Pulse per session | Sham method | Main outcomes | Assessment time |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Ahmadizadeh et al.35 | RCT | PTSD |
B-rTMS = 19 R-rTMS = 19 Sham = 20 |
rTMS/20 Hz | RDLPFC and BDLPFC |
10 sessions 24000 pulses |
100% RMT | 1200 | Sham coil | PCL-M |
Baseline Session5 Session 10 |
| Boggio et al.45 | RCT | PTSD |
RDLPFC = 10 LDLPFC = 10 Sham = 10 |
rTMS/20 Hz | RDLPFC and LDLPFC |
10 sessions 16000 pulses |
80%RMT | 1600 | Sham coil |
PCL-5 Treatment Outcome PTSD Scale HARS HDRS |
Baseline Session5 Session 10 2 weeks FU 4 weeks FU 8 weeks FU 12 weeks FU |
| Carpenter et al.42 | Open-label | PTSD and MDD | N = 35 | rTMS/5 Hz | LPFC |
40 sessions 3000 pulses |
120%RMT | 3000 | N/A |
PCL-5 IDS-SR PHQ-9 DASS PSS CGI-S PGI-S |
Pre Post |
| Cohen et al.46 | RCT | PTSD |
10Hz-rTMS = 10 1Hz-rTMS = 8 sham rTMS = 6 |
rTMS/1 Hz and 10 Hz | RDLPFC |
10 sessions 200 min |
80% RMT | / | Coil rotation (vertical to RDLPFC) |
PCL-5 Treatment Outcome PTSD Scale HARS HDRS CAPS |
Baseline 5 session 10 session 2 weeks FU 14 days |
| Fryml et al.36 | RCT | PTSD |
EG = 5 CG = 3 |
rTMS/10 Hz | RDLPFC + LDLPFC |
8 sessions 48000 pulses |
120% RMT | 6000 | Sham stimulation |
CAPS Ham-D Ham-A PTSD Checklist |
Pre post |
| Isserles et al.47 | RCT | PTSD | 9:9:8 | dTMS/20 Hz | Bilateral MPFC |
12 sessions 20160 pulses |
120% RMT | 1680 | Sham coil |
CAPS PSS-SR HDRS-24 BDI |
Pre post 2 weeks FU 2 months FU |
| Kozel et al.37 | RCT | PTSD |
EG (rTMS+CPT) = 54 CG (sham rTMS + CPT) = 49 |
rTMS/1 Hz | RDLPFC |
12 sessions 21600 pulses |
110% RMT | 1800 | Sham coil |
CAPS PCL M-PTSD QIDS-SR |
Baseline Session 5 Session 9 1 month FU 3 months FU 6 months FU |
| Kozel et al.38 | RCT | PTSD |
1Hz-rTMS =17 10Hz-rTMS = 18 |
rTMS/1 Hz and 10 Hz | RDLPFC |
36 sessions 86400 pulses |
110% RMT | 2400 | / |
PCL-5 CAPS QIDS-SR MADRS Pain Score NSI |
Pre Post 1 month FU 3 months FU |
| Nam et al.49 | RCT | PTSD |
EG = 7 CG = 9 |
rTMS/1 Hz | RDLPFC |
15 sessions 18600 pulses |
100%MT | 1200 | Coil rotation (vertical to RDLPFC) | CAPS |
Pre Session 10 1 week FU 5 weeks FU |
| Osuch et al.50 | RCT (cross over) | PTSD |
Active rTMS = 5 Sham rTMS = 5 |
rTMS/1 Hz | RDLPFC |
20 sessions 36000 pulses |
100%MT | 1800 | Coil rotation 45°to head) |
CAPS HDRS IES |
Pre Post |
| Oznur et al.39 | Open-label | PTSD | N = 20 | TMS/1 Hz | RDLPFC | 6 | 80% | 600 | / |
BDI BAI IES |
/ |
| Philip et al.43 | Open-label | PTSD and MDD | N = 10 | rTMS/5 Hz | LDLPFC |
30 + 6 sessions 10800 pulses |
120%RMT | 3000 | / |
PCL QIDS |
Pre Session 5 Session 10 Session 15 Session 20 Session 25 Post |
| Philip et al.8 | Open-label | PTSD and MDD | N = 31 | rTMS/5 Hz | LDLPFC | 40 | / | 3000-4000 | / |
PCL IDS-SR MRI |
Pre Post |
| Philip et al.40 | RCT | PTSD and MDD |
EG = 25 CG = 25 |
iTBS | RDLPFC |
10 sessions 18000 pulses |
80%AMT | 1800 | / |
CAPS Social and Occupational Functioning Assessment Scale QOL PCL IDS-SR |
Pre Post 1 month FU |
| Philip et al.41 | RCT | PTSD and MDD |
EG = 25 CG = 25 |
sTMS | / | 10 sessions | / | / | / |
PCL-5 PTSD threshold symptoms QIDS-SR |
Pre Post |
| Rosenberg et al.26 | RCT | PTSD and MDD |
10 Hz = 6 1 Hz = 6 |
TMS/1 Hz and 5 Hz | LDLPFC | 10 sessions | 90%RMT | 600 | / |
SCID-C Ham-D USC-REMT MSCS POMS |
Pre Post 1 month FU 2 months FU |
| Watts et al.44 | RCT | PTSD and MDD |
EG = 10 CG = 10 |
rTMS/1 Hz | RDLPFC | 10 sessions | 90%RMT | / | Sham coil |
CAPS PCL BDI STAI BNCE |
Pre Post 1 month FU 2 months FU |
| Woodside et al.48 | open-lable | PTSD and eating disorder | N = 14 | rTMS (10 Hz and 20 Hz) and iTBS | DMPFC | 20–30 sessions | 120%RMT | 3000 and 1500 | / |
PCL-C DERS |
Pre Post |
| Ahmadizadeh et al.22 | RCT | PTSD |
EG = 18 CG = 16 |
Anodal tDCS | RDLPFC and LDLPFC | 10 sessions | 2 mA | / | / |
PCL-5 BDI-II BAI |
Pre Post 1 month FU |
| Wout et al.23 | RCT | PTSD |
EG = 6 CG = 6 |
tDCS | VMPFC | 6 sessions | 2 mA | / | / |
SCR PCL-5 |
Pre Post 1 month FU |
RCT randomized controlled trial, B-rTMS bilateral repetitive transcranial magnetic stimulation, R-rTMS right repetitive transcranial magnetic stimulation, RDLPFC right dorsolateral prefrontal cortex, BDLPFC bilateral dorsolateral prefrontal cortex, RMT resting moter threshold, PCL-M PTSD checklist military version, LDLPFC left dorsolateral prefrontal cortex, PCL-5 PTSD checklist for DSM-5, HARS Hamilton Anxiety Rating Scale, HDRS Hamilton Depression Rating Scale, FU follow-up, MDD major depression disorder, LPFC left prefrontal cortex, IDS-SR Inventory of Depressive Symptomatology, PHQ-9 Patient Health Questionnaire, DASS Depression Anxiety Stress Scale, PS: Perceived Stress Scale, CGI-S global illness severity, PGI-S patient self-rated version, CAPS Clinician-Administered PTSD Scale-II, EG experiment group, CG control group, Ham-D Hamilton Rating Scale for Depression, Ham-A Hamilton Rating Scale for Anxiety, MPFC medial prefrontal cortex, PSS-SR PTSD symptom scale-self report version, HDRS-24 Hamilton Depression Rating Scale 24 items, BDI Beck Depression Inventory II, CPT cognitive processing therapy, PCL PTSD check list, M-PTSD Mississippi Scale for Combat Related PTSD, QIDS-SR quick inventory of depressive symptomatology-self report Version, MADRS Montgomery- Asberg Depression Rating Scale, NSI neurobehavioral symptom inventory, BAI The beck anxiety inventory, self-report, IES Impact of Events Scale, MRI magnetic resonance imaging, QOL quality of life, SCID-C Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version, USC-REMT University of Southern California Repeatable Episodic Memory Test, MSCS Mississippi Scale of Combat Severity, POMS Profile of Mood States Subscales, STAI The State Trait Anxiety Inventory, BNCE The Brief Neurobehavioral Cognitive Examination, DERS Difficulties in Emotional Regulation Scale, VMPFC ventromedial prefrontal cortex, BDI-II The Beck depression inventory-II, SCR skin conductance reactivity.