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已发表论文
重复经颅磁刺激对创伤后应激障碍的影响及参数探讨：基于随机对照试验的荟萃分析
Authors Wang YX, Lin JY , Zhang CY, Liu JJ , Hou BQ, Nie Q, Lu J, Xie YL
Received 29 May 2025
Accepted for publication 1 September 2025
Published 18 September 2025 Volume 2025:21 Pages 2145—2163
DOI https://doi.org/10.2147/NDT.S532443
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Rakesh Kumar
Yin-Xu Wang,1,* Jing-Yi Lin,1,* Chun-Yu Zhang,2,* Jing-Jing Liu,1 Bang-Qiang Hou,1 Qiu Nie,1 Juan Lu,3 Yu-Lei Xie1
1Department of Rehabilitation Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, People’s Republic of China; 2Department of Clinical Medicine, The Affiliated Hospital of Southwest Medical University, Stem Cell Immunity and Regeneration Key Laboratory of Luzhou, Luzhou, Sichuan, People’s Republic of China; 3Baoshihua Hospital, Chengdu, Sichuan, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Juan Lu, Baoshihua Hospital, Chengdu, Sichuan, 610000, People’s Republic of China, Email 383385128@qq.com Yu-Lei Xie, Department of Rehabilitation Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, 637000, People’s Republic of China, Email xieyulei123@foxmail.com
Background: Recovery from posttraumatic stress disorder (PTSD) is an urgent clinical issue. Repetitive transcranial magnetic stimulation (rTMS) has shown advantages in treating PTSD. However, the quality of existing evidence is low. This review aims to evaluate the efficacy and safety of rTMS for PTSD and to explore the key parameters that influence its therapeutic effects.
Methods: We searched five electronic databases from their inception through September 22, 2024. Eligible studies were screened and data were extracted; the methodological quality of the included trials was assessed. Meta-analysis was performed using RevMan 5.3, and dose–response analysis was conducted with Stata 18.0.
Results: Fifteen studies involving 760 patients were included. There was no statistically significant difference between high-frequency rTMS (HF-rTMS) and low-frequency rTMS (LF-rTMS) (p = 0.24). Neither the > 80% motor threshold (MT) group nor the > 10-day treatment group differed significantly from their respective control groups (80% MT and ≤ 10 days; p > 0.05). The dose-response analysis showed no linear relationship between MT and PTSD Checklist (PCL) (nonlinearity test P=0.008< 0.05), whereas a linear relationship was observed between treatment sessions and PCL scores (linearity test P=0.001< 0.05, nonlinearity test P=0.631> 0.05). As the treatment sessions increased, the PCL scores decreased in a dose-dependent manner.
Conclusion: rTMS is an effective and noninvasive treatment for PTSD. However, study findings suggest that there are no statistically significant differences between HF-rTMS and LF-rTMS, or between > 80% MT and < 80% MT groups. Dose–response analysis indicates a positive correlation between increased number of sessions and symptom improvement. Despite limitations such as small sample sizes and high heterogeneity that may affect the robustness and generalizability of the results, this study still recommends prioritizing high-frequency rTMS and increased treatment sessions to enhance therapeutic outcomes.
Keywords: post-traumatic stress disorder, repetitive transcranial magnetic stimulation, non-invasive neuromodulation
1Department of Rehabilitation Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, People’s Republic of China; 2Department of Clinical Medicine, The Affiliated Hospital of Southwest Medical University, Stem Cell Immunity and Regeneration Key Laboratory of Luzhou, Luzhou, Sichuan, People’s Republic of China; 3Baoshihua Hospital, Chengdu, Sichuan, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Juan Lu, Baoshihua Hospital, Chengdu, Sichuan, 610000, People’s Republic of China, Email 383385128@qq.com Yu-Lei Xie, Department of Rehabilitation Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, 637000, People’s Republic of China, Email xieyulei123@foxmail.com
Background: Recovery from posttraumatic stress disorder (PTSD) is an urgent clinical issue. Repetitive transcranial magnetic stimulation (rTMS) has shown advantages in treating PTSD. However, the quality of existing evidence is low. This review aims to evaluate the efficacy and safety of rTMS for PTSD and to explore the key parameters that influence its therapeutic effects.
Methods: We searched five electronic databases from their inception through September 22, 2024. Eligible studies were screened and data were extracted; the methodological quality of the included trials was assessed. Meta-analysis was performed using RevMan 5.3, and dose–response analysis was conducted with Stata 18.0.
Results: Fifteen studies involving 760 patients were included. There was no statistically significant difference between high-frequency rTMS (HF-rTMS) and low-frequency rTMS (LF-rTMS) (p = 0.24). Neither the > 80% motor threshold (MT) group nor the > 10-day treatment group differed significantly from their respective control groups (80% MT and ≤ 10 days; p > 0.05). The dose-response analysis showed no linear relationship between MT and PTSD Checklist (PCL) (nonlinearity test P=0.008< 0.05), whereas a linear relationship was observed between treatment sessions and PCL scores (linearity test P=0.001< 0.05, nonlinearity test P=0.631> 0.05). As the treatment sessions increased, the PCL scores decreased in a dose-dependent manner.
Conclusion: rTMS is an effective and noninvasive treatment for PTSD. However, study findings suggest that there are no statistically significant differences between HF-rTMS and LF-rTMS, or between > 80% MT and < 80% MT groups. Dose–response analysis indicates a positive correlation between increased number of sessions and symptom improvement. Despite limitations such as small sample sizes and high heterogeneity that may affect the robustness and generalizability of the results, this study still recommends prioritizing high-frequency rTMS and increased treatment sessions to enhance therapeutic outcomes.
Keywords: post-traumatic stress disorder, repetitive transcranial magnetic stimulation, non-invasive neuromodulation