외상후 스트레스 장애의 경두개자기자극치료

Transcranial Magnetic Stimulation Treatment in Patients with Posttraumatic Stress Disorder

Objectives：Transcranial magnetic stimulation (TMS) is a novel, noninvasive method of brain stimulation. As the knowledge of the neuroanatomical abnormalities of posttraumatic stress disorder (PTSD) has been increased, therapeutic application of TMS has been suggested in patients with PTSD. Thus we reviewed the literatures to look into the effectiveness of TMS for the treatment of PTSD. Methods：We described the published clinical studies of TMS in patients with PTSD using literature review and our preliminary results of clinical trial for integrating the future direction of TMS research in the treatment of PTSD. Results：Although the previous studies for the treatment of PTSD were scanty, TMS might be an tolerable and safe option for the intervention of PTSD. Several studies suggested that repeated rhythmic TMS (rTMS) to right prefrontal cortex might be useful for the treatment of PTSD. The accurate mechanism of rTMS has not been known yet. However, it is supposed that rTMS may have the ability to normalize brain metabolism, improve neuronal functional connectivity and modulate the neuronal circuitry in patients with PTSD. This capability has raised the possibility of the use of rTMS as a novel therapeutic tool for PTSD. Conclusion：In order to optimize rTMS for therapeutic use in PTSD, it is necessary to determine rTMS treatment parameters, such as frequency, intensity, pulse duration and stimulation site, pulse width, intertrain interval, coil type, numbers of sessions, and interval between sessions. rTMS would be a relatively new and noninvasive method for exploring the regional brain circuitry of PTSD