Changes in Trauma-based Intrusive Memory Characteristics Associated with Repetitive Transcranial Magnetic Stimulation (rTMS) for Depression: A Daily Diary Study

The present study investigated whether repetitive transcranial magnetic stimulation (rTMS) for depression reduced trauma-based intrusive memory frequency and associated pathological characteristics such as intensity and distress. Traumatic stress symptoms and general psychopathology outcomes were also investigated. Inpatients at a psychiatric hospital (N = 25) referred for 20-sessions of rTMS for depression completed daily ratings of trauma-related intrusive memory frequency and characteristics. Linear mixed models and repeated measures t-tests were used to analyze the course of change for intrusive memories. Effect sizes and reliable change were also analyzed. Non-linear decreases for intrusive memory frequency and associated characteristics were reported over the course of treatment, with the changes from Days 0 to 7 being sustained at Day 20. Large effect sizes were reported for measures of traumatic stress, and re-experiencing, depression, and stress symptoms. Reliable change was most commonly indicated for measures of traumatic stress and general mental health. Limitations of the study include the lack of a control group and small sample size. To the best of our knowledge, this study is the first to use a within-subject daily-sampling design to monitor intrusive memories, in an inpatient setting, within the context of rTMS treatment. Routine rTMS for depression appears beneficial for reducing trauma-based intrusive memories as well as PTSD symptoms more generally. The present study demonstrates clinical viability of extending routine rTMS protocols used for depression to trauma-based intrusive memories and associated symptomatology.