JAMA Netw Open
Brain stimulation device boosts PTSD response to psychotherapy
Clinical takeaway: MRI-guided TMS may enhance response to psychotherapy in severe PTSD, but remains adjunctive and resource-intensive.
Combat-related PTSD is often resistant to standard therapy. This randomized trial tested whether adding MRI-guided, robotically delivered transcranial magnetic stimulation (TMS) to intensive psychotherapy improves outcomes.
All 119 active-duty and veteran participants received intensive psychotherapy; one group also received active TMS for up to 20 sessions over 30 days, while the other received a sham procedure. Psychotropic medications were commonly used at baseline and remained stable during the trial, with similar use across groups.
Clinically significant symptom improvement at one month was achieved in 85% of the active TMS group vs. 59% of the sham group, with benefits sustained at three months. Improvements were seen across both patient-reported and clinician-rated measures, with greater durability in the active group.
This was a single-site study involving predominantly severe or extreme cases of PTSD, and the intervention required specialized MRI-guided delivery, which may limit generalizability.
Source: Fox PT, et al. JAMA Netw Open. April 7, 2026. Residential Therapy With Navigated Transcranial Magnetic Stimulation for Combat-Related PTSD