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Ventrolateral prefrontal cortex repetitive transcranial magnetic stimulation in the treatment of depersonalization disorder: a consecutive case series

Research output: Contribution to journalArticlepeer-review

Original languageEnglish
JournalPsychiatry Research
Early online date13 Apr 2016
DOIs
Accepted/In press11 Apr 2016
E-pub ahead of print13 Apr 2016

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  • 1-s2.0-S0165178115305564-main

    1_s2.0_S0165178115305564_main.pdf, 1.22 MB, application/pdf

    Uploaded date:14 Apr 2016

    Version:Accepted author manuscript

    Licence:CC BY-NC-ND

King's Authors

Abstract

Case reports and an open trial have reported promising responses to repetitive transcranial magnetic stimulation (rTMS) to prefrontal and tempero-parietal sites in patients with depersonalization disorder (DPD). We recently showed that a single session of rTMS to the ventrolateral prefrontal cortex (VLPFC) was associated with a reduction in symptoms and increase in physiological arousal. Seven patients with medication-resistant DSM-IV DPD received up to 20 sessions of right-sided rTMS to the VLPFC for 10 weeks. Stimulation was guided using neuronavigation software based on participants’ individual structural MRIs, and delivered at 110% of resting motor threshold. A session consisted of 1 Hz repetitive TMS for 15 minutes. The primary outcome measure was reduction in depersonalization symptoms on the Cambridge Depersonalisation Scale (CDS). Secondary outcomes included scores on the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). 20 sessions of rTMS treatment to right VLPFC significantly reduced scores on the CDS by on average 44% (range 2-83.5%). Two patients could be classified as “full responders”, four as “partial” and one a non-responder. Response usually occurred within the first 6 sessions. There were no significant adverse events. A randomized controlled clinical trial of VLPFC rTMS for DPD is warranted.

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