This article discusses the application of deep transcranial magnetic stimulation (dTMS) in treating post-traumatic stress disorder (PTSD). It highlights the mechanism by which dTMS activates the medial prefrontal cortex (mPFC) to inhibit the overactive amygdala, thereby alleviating fear responses associated with PTSD.
Begin with a patient diagnosed with post-traumatic stress disorder, or PTSD.
This disorder causes reduced activity in the medial prefrontal cortex, or mPFC, thereby preventing inhibition of the amygdala.
As a result, the amygdala, a fear-processing center, becomes overactive, leading to heightened and persistent fear responses.
Using the guide cap on the patient’s head, position the deep transcranial magnetic stimulation, or dTMS, helmet over the right motor cortex.
The helmet contains a magnetic coil wound in multiple planes, which generates a magnetic field that penetrates deeper brain regions to activate target areas effectively.
Apply minimum intensity pulses to the motor cortex to trigger hand muscle contraction.
Reposition the helmet over the mPFC and deliver suprathreshold pulses to stimulate neural activity.
Increasing mPFC activation restores its inhibitory control over the amygdala, thereby reducing fear responses and alleviating PTSD symptoms.
Begin by placing the blue cap with the two intercepting rulers, on to the subject. Then place the zero cm mark of the white sagittal ruler on the nasion. And the 25 cm mark of the clear coronal ruler, at 40%of the nasion-inion distance, with the zero on the left side of the patient's head.
Use the helmet to find the resting motor threshold or MT, of the right hand, by starting with the front of the helmet, seven cm from the nasion, and the left side of the coil tilted two cm to the right. Then, identify the minimal motor threshold, also known as the hot spot.
Begin by pressing repetitive mode on the stimulator touch screen. Then, enter the parameters by touching the boxes on the screen, and adjusting them using the side wheel.
Press, run session. Charge the machine by pressing the green button. Warn the patient that the stimulation is starting.
Then start the stimulation with the yellow button.
Move the helmet six cm forward along the saggital ruler, from the motor cortex, to reach the medial PFC, while keeping the helmet symmetrical. Then place the coil over the medial PFC, symmetrically with respect to right left. With the zero mark on the helmet's front edge aligned with the three cm mark on the saggital ruler of the cap.
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