Repetitive TMS combined with exposure therapy for PTSD: A preliminary study

Elizabeth A. Osuch, Brenda E. Benson, David A. Luckenbaugh, Marilla Geraci, Robert M. Post, Una McCann

Research output: Contribution to journalArticlepeer-review


Treatment for anxiety and post-traumatic stress disorder (PTSD) includes exposure therapy and medications, but some patients are refractory. Few studies of repetitive transcranial magnetic stimulation (rTMS) for anxiety or PTSD exist. In this preliminary report, rTMS was combined with exposure therapy for PTSD. Nine subjects with chronic, treatment-refractory PTSD were studied in a placebo-controlled, crossover design of imaginal exposure therapy with rTMS (1 Hz) versus sham. PTSD symptoms, serum and 24 h urine were obtained and analyzed. Effect sizes for PTSD symptoms were determined using Cohen's d. Active rTMS showed a larger effect size of improvement for hyperarousal symptoms compared to sham; 24-h urinary norepinephrine and serum T4 increased; serum prolactin decreased. Active rTMS with exposure may have symptomatic and physiological effects. Larger studies are needed to confirm these preliminary findings and verify whether rTMS plus exposure therapy has a role in the treatment of PTSD.

Original languageEnglish (US)
Pages (from-to)54-59
Number of pages6
JournalJournal of Anxiety Disorders
Issue number1
StatePublished - Jan 2009
Externally publishedYes


  • Extinction
  • Post-traumatic stress disorder (PTSD)
  • Psychological desensitization
  • Psychological therapies
  • Transcranial magnetic stimulation (TMS)

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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