People suffering from PSD can feel frightened or stressed even when they are not in danger anymore.
It emerges after a crushing and terrifying experience that involves physical damage or threats the individual. The person who develops it may have been directly affected or it may have happened to loved ones or even strangers. Violations, wars, catastrophes, among others, are propitious situations that may generate PSD. The current trend is that genetics play a role in the creation of fear. In the absence of other substances to be determined, serotonin can boost the fear response.
Prefrontal cortex, thalamus and amygdale are some of the brain structures involved in dealing with fear and stress. Environmental factors, infantile trauma, head injury, or history of mental disorder, may increase the risk of suffering from PSD.
PSD signs and symptoms may be grouped in three categories:
1. Re-experimentation symptoms
2. Avoidance symptoms
3. Hyperactivation symptoms
Diagnostic: not all traumatized people develop PSD. Symptoms begin three months after the event, but in some cases several years go by until the appearance of symptoms. It should be at least three months to be catalogued as PSD.
Treatment: psychotherapy is carried out by Cognitive Behavioral Therapy and/or Group Therapy from 6 to 12 weeks. Medicines used are antidepressants, especially Sertraline and Paroxetine.
Another kind of treatment that has emerged in the recent years is desensitization and reprocessing of eye movement (DREM). This method combines rapid eye movements with a reconstruction of the traumatic event, but the response is a function of each patient and it is demanding and expensive, so abandonment is not uncommon.
In the Neurosciences field, neuromodulation, modifies and harmonizes neural activity through pharmaceutical, electrical, mechanical agents in different areas of the body to treat different diseases or symptoms. Neuromodulation counts with technological tools that act specifically on neural structures.
“Neuromodulation” therapy should be considered for selected patients through a multidisciplinary evaluation, either as a complement of other type of care, or as an alternative when symptoms do not respond properly to more conservative choices. For example, when existent medicines are ineffective or become a problem by developing tolerance, addiction, adverse side effects or toxicity.
Neuromodulation therapies continue to experience refinement through ongoing research that elucidates its applications.
Among the non-invasive Neuromodulation techniques we find deep Transcranial Magnetic Stimulation, clearly differentiated from superficial stimulation.
Stimulation coils – H-Coil – embedded in a helmet and developed according to the three-dimensional cytoarchitecture of the brain, allow stimulating subcortical circuits and nodes, not only transcortical synapses as with conventional Magnetic Stimulation, also known as superficial TMS.
Deep TMS (BrainsWay) is used to treat PSD and it brings considerable improvement to people who suffer without causing side effects.
Treatment through deep TMS is effective, secure and non-invasive; it does not require hospitalization or anesthesia. It is administered on an outpatient basis.
Procedure consists of description of the event that is written down by the patient the first day of the treatment, 2/3 parts of a sheet of paper. Patient must read such writing before receiving the treatment with deep TMS every day until its finalization.
The technique, procedure and patent have been approved by the EMA-CE and comply with the regulations of guarantee required by current legislation.
Efficacy of Brainsway Deep TMS for PTSD
- Isserles M, Shalev AY, Roth Y, Peri T, Kutz I, Zlotnick E, et al. Effectiveness of deep transcranial magnetic stimulation combined with a brief exposure procedure in post-traumatic stress disorder - A pilot study. Brain Stimul 2013;6:377-383.
- Revue of the effectiveness of Transcranial Magnetic Stimulation for Oost-Traumatic Stress Disorder. Ethan F.Karsen, Bradley V. Watts, Paul E. Holtzheimer. Brain Stimulation. March-April, 2014. Vol. 7. Issue 2, Pages 151-157.
- Noninvasive brain stimulation with high-frequency and low intensity repetitive transcranial magnetic stimulation for posttraumatic stress disorder. 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. J Clin Psychiatry. 2010 Aug;71(8):992-9. Epub 2009 Dec 29.
- Effect of Transcranial Magnetic Stimulation in Postraumatic Stress Disorder: a preliminaty study. Grisaru N, Amir M, Chen H, Kaplan Z,. Biol. Phichiatry. 1998. Jul 1;44(1): 52-55.
- Transcranial Magnetic Stimulation for Panic. Zwanzger et al; American Journal of Psychiatry. 2002. Febrer; 159(2): 315-6.
- Repetitive Transcranial Magnetic Stimulation for Post-Traumatic Stress Disorder. McCann et al. Arch. Gen Psychiatry. 1998; 55: 276-279.