PMID- 32601710 OWN - NLM STAT- MEDLINE DCOM- 20210413 LR - 20210413 IS - 1930-613X (Electronic) IS - 0026-4075 (Linking) VI - 185 IP - 9-10 DP - 2020 Sep 18 TI - Exploring Theta Burst Stimulation for Post-traumatic Stress Disorder in Australian Veterans-A Pilot Study. PG - e1770-e1778 LID - 10.1093/milmed/usaa149 [doi] AB - INTRODUCTION: Post-traumatic stress disorder (PTSD) is a severe and debilitating condition affecting a significant proportion of the veteran community. A substantial number of veterans with PTSD fail to benefit from trauma-focused psychological therapies or pharmacotherapy or are left with residual symptoms, and therefore, investigation of new and innovative treatment is required. Theta Burst Stimulation (TBS) is a novel form of Repetitive Transcranial Magnetic Stimulation, which has been shown to improve depression symptoms and associated cognitive deficits. The current pilot study aimed to explore the acceptability, safety, and tolerability of intermittent TBS (iTBS) as a treatment for PTSD in Australian veterans. MATERIALS AND METHODS: This study employed a case series, repeated-measures design. Eight Australian Defence Force veterans with PTSD received 20 bilateral iTBS treatments (1 session per day, 5 days per week over a 4-week period) and were assessed on a range of mental health and neuropsychological measures, including the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) and Hamilton Depression Rating Scale (HAM-D), at pretreatment, post-treatment, and a 3-month follow-up. RESULTS: Treatment was generally welltolerated, with reported side-effects including mild to moderate site-specific cranial pain and headaches during stimulation, which were relieved with the use of low dose analgesics. No serious side effects or adverse events were reported. Participants exhibited reductions in both PTSD and depression symptom severity (the repeated-measures effect size [dRM] for the CAPS-5 was -1.78, and the HAM-D was -1.16 post-treatment), as well as improvements in working memory and processing speed. Although significance cannot be inferred, these preliminary estimates of effect size indicate change over time. CONCLUSIONS: Bilateral iTBS appears to be welltolerated by Australian veterans. Within this repeated-measures case series, iTBS treatment shows promise in reducing both PTSD and mood symptoms, as well as improving cognitive difficulties associated with these disorders. Large-scale randomized controlled trials of this promising treatment are warranted. CI - (c) Association of Military Surgeons of the United States 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. FAU - Nursey, Jane AU - Nursey J AD - Phoenix Australia - Centre for Post-traumatic Mental Health, Department of Psychiatry, University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, Victoria 3053, Australia. FAU - Sbisa, Alyssa AU - Sbisa A AD - Phoenix Australia - Centre for Post-traumatic Mental Health, Department of Psychiatry, University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, Victoria 3053, Australia. FAU - Knight, Holly AU - Knight H AD - Phoenix Australia - Centre for Post-traumatic Mental Health, Department of Psychiatry, University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, Victoria 3053, Australia. FAU - Ralph, Naomi AU - Ralph N AD - Phoenix Australia - Centre for Post-traumatic Mental Health, Department of Psychiatry, University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, Victoria 3053, Australia. FAU - Cowlishaw, Sean AU - Cowlishaw S AD - Phoenix Australia - Centre for Post-traumatic Mental Health, Department of Psychiatry, University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, Victoria 3053, Australia. FAU - Forbes, David AU - Forbes D AD - Phoenix Australia - Centre for Post-traumatic Mental Health, Department of Psychiatry, University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, Victoria 3053, Australia. FAU - O'Donnell, Meaghan AU - O'Donnell M AD - Phoenix Australia - Centre for Post-traumatic Mental Health, Department of Psychiatry, University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, Victoria 3053, Australia. FAU - Hinton, Mark AU - Hinton M AD - Phoenix Australia - Centre for Post-traumatic Mental Health, Department of Psychiatry, University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, Victoria 3053, Australia. FAU - Cooper, John AU - Cooper J AD - Phoenix Australia - Centre for Post-traumatic Mental Health, Department of Psychiatry, University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, Victoria 3053, Australia. FAU - Hopwood, Malcolm AU - Hopwood M AD - University of Melbourne Professorial Psychiatry Unit, Albert Road Clinic, 31 Albert Road, Melbourne, Victoria 3004, Australia. FAU - McFarlane, Alexander AU - McFarlane A AD - Centre for Traumatic Stress Studies, The University of Adelaide, Adelaide, South Australia 5005, Australia. FAU - Herring, Sally AU - Herring S AD - Epworth Centre for Innovation in Mental Health (ECIMH), 888 Toorak Rd, Camberwell, Victoria 3124, Australia. FAU - Fitzgerald, Paul AU - Fitzgerald P AD - Epworth Centre for Innovation in Mental Health (ECIMH), 888 Toorak Rd, Camberwell, Victoria 3124, Australia. AD - Monash Alfred Psychiatry Research Centre, Monash University, Central Clinical School and the Alfred, The Alfred Centre, 99 Commercial Rd, Melbourne, Victoria 3004, Australia. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - England TA - Mil Med JT - Military medicine JID - 2984771R SB - IM MH - Australia MH - Humans MH - Pilot Projects MH - *Stress Disorders, Post-Traumatic/therapy MH - Transcranial Magnetic Stimulation MH - Treatment Outcome MH - *Veterans EDAT- 2020/07/01 06:00 MHDA- 2021/04/14 06:00 CRDT- 2020/07/01 06:00 PHST- 2020/01/31 00:00 [received] PHST- 2020/05/04 00:00 [revised] PHST- 2020/06/01 00:00 [accepted] PHST- 2020/07/01 06:00 [pubmed] PHST- 2021/04/14 06:00 [medline] PHST- 2020/07/01 06:00 [entrez] AID - 5864875 [pii] AID - 10.1093/milmed/usaa149 [doi] PST - ppublish SO - Mil Med. 2020 Sep 18;185(9-10):e1770-e1778. doi: 10.1093/milmed/usaa149.