Dorsomedial prefrontal cortex repetitive transcranial magnetic stimulation treatment of posttraumatic stress disorder in eating disorders: An open-label case series

Posttraumatic stress disorder (PTSD) is a common comorbid condition in anorexia nervosa (AN) and bulimia nervosa (BN), and may be associated with reduced response to treatment. We report on a case series employing repetitive transcranial magnetic stimulation (rTMS) with a novel target, the dorsomedial prefrontal cortex (DMPFC). Fourteen subjects with eating disorders and comorbid PTSD received 20–30 neuronavigated DMPFC–rTMS treatments on an open-label basis. PTSD symptoms were assessed pretreatment and posttreatment with the PTSD checklist-Civilian (PCL-C) and the Difficulties in Emotional Regulation Scale (DERS). PCL-C scores were reduced by 51.99% ± 27.24% overall, from a mean of 54.29?±?19.34 pretreatment to 24.86?±?17.43 posttreatment (p?50%. DERS scores improved by 36.02% ± 24.24% overall, from 140.00?±?22.09 at pretreatment to 89.29?±?38.31 at posttreatment (p?50% improvement. These data may suggest that DMPFC–rTMS could be helpful in the treatment of PTSD in some ED patients.