1. Improvement in borderline personality disorder symptomatology after repetitive transcranial magnetic stimulation of the dorsomedial prefrontal cortex: preliminary results
- Author
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Marbella Espino-Cortés, Julian V. Reyes-López, Josefina Ricardo-Garcell, Mario Barbosa-Luna, Nancy G. Hernández‐Chan, Georgina Roque-Roque, Lorena García-Noguez, Hebert Luis Hernández-Montiel, René Francisco Rodríguez-Valdés, Sofía Cañizares-Gómez, Angel R. Calderón-Moctezuma, and Gerardo Trejo-Cruz
- Subjects
Hamilton Anxiety Rating Scale ,RC435-571 ,Prefrontal Cortex ,Anxiety ,Brief Communication ,behavioral disciplines and activities ,dorsomedial prefrontal cortex ,03 medical and health sciences ,0302 clinical medicine ,Rating scale ,mental disorders ,medicine ,Humans ,HARS ,Prefrontal cortex ,Borderline personality disorder ,Psychiatry ,business.industry ,Neuropsychology ,repetitive transcranial magnetic stimulation ,medicine.disease ,Anxiety Disorders ,Transcranial Magnetic Stimulation ,030227 psychiatry ,Psychiatry and Mental health ,Treatment Outcome ,Clinical Global Impression ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Clinical psychology - Abstract
Objective: Current treatment for borderline personality disorder (BPD) involves psychological and pharmacological interventions. However, neuromodulation techniques such as repetitive transcranial magnetic stimulation (rTMS) may positively affect BPD symptomatology. The objective of this study was to evaluate the clinical and neuropsychological effects of rTMS on the dorsomedial prefrontal cortex (DMPFC) in BPD patients. Methods: Fourteen patients with BPD were randomized into two groups (active vs. sham) for 15 sessions of rTMS on the DMPFC. Clinical effects were measured using the Borderline Symptoms List (BSL), Clinical Global Impression Scale for BPD (CGI-BPD), Borderline Evaluation of Severity over Time (BEST), Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), and Barratt’s Impulsiveness Scale (BIS). Neuropsychological effects were determined by a Stop-Signal Task (SST), the Wisconsin Card-Sorting Test (WCST), and the Iowa Gambling Test (IGT). Results: Within-group comparison showed significant differences (p < 0.05) in CGI-BPD (total score and six of nine psychopathologic domains), BEST, HDRS, HARS, and IGT scores for active modality. Conclusion: The 5 Hz-DMPFC rTMS technique was well tolerated and lessened the severity of BPD symptomatology, especially abandonment, affective issues, interpersonal relationships, suicidal behavior, anger, and paranoid ideation. Cognitive improvement was seen in decision-making. Additional studies are needed to fully evaluate the effects of rTMS on BPD symptomatology. Clinical Trial Registration: NCT03832777.
- Published
- 2020