International Journal of Neurology and Brain DisordersInternational Journal of Neurology and Brain DisordersInternational Journal of Neurology and Brain DisordersInternational Journal of Neurology and Brain Disorders2377-1348Ommega Online PublishersNew Jersey, USA114310.15436/2377-1348.16.1143Research ArticleSuccessful Treatment of a Patient with Generalized Anxiety Disorder Using Dual-Site Transcranial Magnetic StimulationSuccessful Treatment of a Patient with Generalized Anxiety Disorder Using Dual-Site Transcranial Magnetic StimulationWitter,Daniel P 1Assistant Professor University of Florida College of Medicine Department of Psychiatry USA 2Medical Director of University of Florida Psychiatric Hospital USA 3PGY4 University of Florida College of Medicine Department of Psychiatry USA Editor* E-mail: dwitter@ufl.edu
The authors have declared that no competing interests exist.
20162112201634IJNBD-16-CR-114328092016141120162016Creative Commons Attribution LicenseThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. nbsp emsp emsp The use of Transcranial Magnetic Stimulation TMS in treatment-resistant cases of certain psychiatric illnesses is an ever-expanding field of research As our understanding of the neurobiological underpinnings of psychiatric illness increases abnormal function in neurocircuits guides the choice of unique targets for neurostimulation therapy Generalized Anxiety Disorder GAD is a common psychiatric disorder with high rates of treatment-resistance and putative functional abnormalities in a variety of frontal and limbic circuits This case highlights the results of a novel dual-site TMS protocol in a 25-year-old female with treatment-resistant GAD The seven week course of treatment combined low frequency TMS over the dorsolateral right prefrontal cortex and high frequency TMS over the dorsolateral left prefrontal cortex This method of treatment resulted in a 91 improvement in GAD symptoms based on by the Hamilton Anxiety Rating Scale and considerable overall functional improvement based on the Clinical Global Impression-Severity scale We propose that TMS may prove useful for treatment-resistant GAD and that targeting multiple sites with TMS may improve outcomes compared to TMS targeting a single site 10