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Journal Académique
POST-TRAUMATIC STRESS DISORDER (PTSD)
| Titre: | Noninvasive brain stimulation with high- and low-frequency repetitive transcranial magnetic stimulation treatment for posttraumatic stress disorder. | | Date: | December 29, 2009 | | Auteur(s): | Boggio PS, Rocha M, Oliveira MO, Fecteau S, Cohen RB, Campanhã C, Ferreira-Santos E, Meleiro A, Corchs F, Zaghi S, Pascual-Leone A, Fregni F. | | Source: | J Clin Psychiatry. | | Résumé : |
OBJECTIVE: We aimed to investigate the efficacy of 20 Hz repetitive transcranial magnetic stimulation (rTMS) of either right or left dorsolateral prefrontal cortex (DLPFC) as compared to sham rTMS for the relief of posttraumatic stress disorder (PTSD)-associated symptoms. METHOD: In this double-blind, placebo-controlled phase II trial conducted between October 2005 and July 2008, 30 patients with DSM-IV-diagnosed PTSD were randomly assigned to receive 1 of the following treatments: active 20 Hz rTMS of the right DLPFC, active 20 Hz rTMS of the left DLPFC, or sham rTMS. Treatments were administered in 10 daily sessions over 2 weeks. A blinded rater assessed severity of core PTSD symptoms, depression, and anxiety before, during, and after completion of the treatment protocol. In addition, a battery of neuropsychological tests was measured before and after treatment. RESULTS: Results show that both active conditions-20 Hz rTMS of left and right DLPFC-induced a significant decrease in PTSD symptoms as indexed by the PTSD Checklist and Treatment Outcome PTSD Scale; however, right rTMS induced a larger effect as compared to left rTMS. In addition, there was a significant improvement of mood after left rTMS and a significant reduction of anxiety following right rTMS. Improvements in PTSD symptoms were long lasting; effects were still significant at the 3-month follow-up. Finally, neuropsychological evaluation showed that active 20 Hz rTMS is not associated with cognitive worsening and is safe for use in patients with PTSD. CONCLUSIONS: These results support the notion that modulation of prefrontal cortex can alleviate the core symptoms of PTSD and suggest that high-frequency rTMS of right DLPFC might be the optimal treatment strategy. © Copyright 2009 Physicians Postgraduate Press, Inc.
| | Titre: |
Posttraumatic Stress Disorder and Health-Related
Quality of Life Among a Sample of Treatment- and
Pension-Seeking Deployed Canadian Forces
Peacekeeping Veterans
| | Date: | September 2008 | | Auteur(s): |
J Don Richardson, MD, FRCPC; Mary E Long, MA, MS; David Pedlar, PhD;
Jon D Elhai, PhD
| | Source: | The Canadian Journal of Psychiatry, Vol 53, No 9, September 2008 | | Mots clés: | quality of life, peacekeepers, posttraumatic stress disorder | | Résumé : |
Objectives: To examine the health-related quality of life (HRQOL) in deployed Canadian
Forces peacekeeping veterans, addressing associations with posttraumatic stress disorder
(PTSD), and depression severity.
Methods: Participants (n = 125) were consecutive male veterans who were referred for a
psychiatric assessment. Instruments administered included the Clinician-Administered
PTSD Scale, Hamilton Depression Scale, Short-Form-36 Health Survey, and
sociodemographic characteristics.
Results: Mental HRQOL was significantly lower for peacekeepers with, than without,
PTSD. Using univariate analyses, PTSD and depression severity were each significantly
negatively related to mental HRQOL. In sequential regression analyses controlling for age,
we found that PTSD and depression severity significantly predicted both mental and
physical HRQOL.
Conclusions: Veterans with PTSD have significant impairments in mental and physical
HRQOL. This information is useful for clinicians and Veterans Affairs administrators
working with the newer generation of veterans, as it stresses the importance of including
measures of quality of life in the psychiatric evaluation of veterans to better address their
rehabilitation needs.
| | Titre: | Repetitive Transcranial Magnetic Stimulation of the Right Dorsolateral Prefrontal Cortex in Posttraumatic Stress Disorder: A Double-Blind, Placebo-Controlled Study. | | Date: | 2004 | | Auteur(s): | Cohen, H., Kaplan, Z., Kotler, M., Kouperman, I., Moisa, R., and Grisaru, N. | | Source: | American Journal of Psychiatry 2004; 161:515-524 | | Mots clés: | Posttraumatic Stress Disorder | | Résumé : | A double-blind, placebo-controlled approve was utilized to determine the efficacy of repertitive Transcranial Magentic Stimulation therapy (rTMS) of the right prefrontal cortex for patients suffering from posttraumatic stress disorder (PTSD). Twenty-four PTSD patients were assessed for PTSD, anxiety abnd depression severity prior, during and post treatments. The subjects were randomly assigned to receive either rTMS at low frequency or high frequency or sham treatments. Treatment duration was two weeks in length with ten daily sessions of 10Hz rTMS at 80% motor threshold at the right dorsolateral prefrontal cortex. These treatments alleviated anxiety symptoms and provided therapeutic effects for PTSD patients, this, suggesting that right dorsolateral prefrontal high rTMS is more beneficial that slow-frequency frequency or sham stimulation. |
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