Innovating transcranial magnetic stimulation treatment for post-traumatic stress disorder: Zapping away the bad memory

Post-traumatic stress disorder (PTSD) is a debilitating psychiatric condition characterized by dysregulated fear memory, emotional disturbances, and impaired cognition, driven by dysfunctions across multiple neural circuits and neuroinflammatory processes. While current treatments demonstrate limited efficacy, repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising non-invasive intervention. This review synthesizes preclinical and clinical evidence, highlighting rTMS mechanisms-including enhanced neuroplasticity, normalizing network connectivity, and reducing neuroinflammation. We then propose five innovative strategies, including accelerated protocols, precision targeting using neuroimaging, neuroinformatic approaches, closed-loop systems, and biomarker-guided treatment. By bridging circuit-level insights with clinical innovation, rTMS offers a transformative approach to PTSD treatment, though standardization and personalized paradigms require further development and validation. Future research should integrate multimodal biomarkers with hybrid therapies to optimize outcomes.