***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Repetitive transcranial magnetic stimulation ( rTMS ) is a noninvasive method that holds promise for treating several psychiatric disorders . Yet the most effective location and parameters for treatment need more exploration . Also , whether rTMS is an effective treatment for individuals with a DSM-IV diagnosis of generalized anxiety disorder ( GAD ) has not been empirically tested . The goal of this pilot study was to evaluate whether functional magnetic resonance imaging (fMRI)-guided rTMS is effective in reducing symptoms of GAD . METHOD Ten participants with a DSM-IV diagnosis of GAD , recruited from the UCLA Anxiety Disorders Program , and between the ages of 18 and 56 years were enrolled in the study from August 2006 to March 2007 . A pretreatment symptom provocation fMRI experiment was used to determine the most active location in the prefrontal cortex of the participants . Ten participants completed 6 sessions of rTMS over the course of 3 weeks , stereotactically directed to the previously determined prefrontal location . The primary efficacy measures were the Hamilton Rating Scale for Anxiety ( HAM-A ) and the Clinical Global Impressions-Improvement of Illness ( CGI-I ) scale . Response to treatment was defined as a reduction of 50 % or more on the HAM-A and a CGI-I score of 1 or 2 ( " very much improved " or " much improved , " respectively ) . RESULTS Overall , rTMS was associated with significant decreases in HAM-A scores ( t = 6.044 , p = .001 ) indicative of clinical improvement in GAD symptoms . At endpoint , 6 ( 60 % ) of the 10 participants who completed the study showed reductions of 50 % or more on the HAM-A and a CGI-I score of 1 or 2 ; those 6 subjects also had an endpoint HAM-A score < 8 , therefore meeting criteria for remission . CONCLUSION Results of the current study suggest that fMRI-guided rTMS treatment may be a beneficial technique for the treatment of anxiety disorders . Limitations include a small sample size and open-label design with a technology that may be associated with a large placebo response . These limitations necessitate further research to determine whether rTMS is indeed effective in treating anxiety disorders We examined the psychometric properties of the  PTSD Checklist ( PCL ) , a self-report instrument design ed to assess symptoms of posttraumatic stress disorder . Three hundred ninety-two participants recruited in a university setting completed the PCL in addition to several well-established self-report instruments design ed to assess various forms of psychopathology ( e.g. , depression , general anxiety , PTSD ) . Ninety participants returned for readministration of selected measures . Findings provided support for psychometric properties of the PCL  , including internal consistency , test – retest reliability , convergent validity , and discriminant validity . Additional strengths of the PCL are discussed Objectives . Neurobiologically , panic disorder ( PD ) is supposed to be characterised by cerebral hypofrontality . Via functional near-infrared spectroscopy ( fNIRS ) , we investigated whether prefrontal hypoactivity during cognitive tasks in PD- patients compared to healthy controls ( HC ) could be replicated . As intermittent theta burst stimulation ( iTBS ) modulates cortical activity , we furthermore investigated its ability to normalise prefrontal activation . Methods . Forty-four PD- patients , r and omised to sham or verum group , received 15 iTBS-sessions above the left dorsolateral prefrontal cortex ( DLPFC ) in addition to psychoeducation . Before first and after last iTBS-treatment , cortical activity during a  verbal fluency task  was assessed via fNIRS and compared to the results of 23 HC . Results . At baseline , PD- patients showed hypofrontality including the DLPFC , which differed significantly from activation patterns of HC . However , verum iTBS did not augment prefrontal fNIRS activation . Solely after sham iTBS , a significant increase of measured fNIRS activation in the left inferior frontal gyrus ( IFG ) during the phonological task was found . Conclusion . Our results support findings that PD is characterised by prefrontal hypoactivation during cognitive performance . However , verum iTBS as an “ add-on ” to psychoeducation did not augment prefrontal activity . Instead we only found increased fNIRS activation in the left IFG after sham iTBS application . Possible reasons including task-related psychophysiological arousal are discussed BACKGROUND We tested whether transcranial magnetic stimulation ( TMS ) over the left dorsolateral prefrontal cortex ( DLPFC ) is effective and safe in the acute treatment of major depression . METHODS In a double-blind , multisite study , 301 medication-free patients with major depression who had not benefited from prior treatment were r and omized to active  ( n = 155 ) or  sham TMS  ( n = 146 ) conditions . Sessions were conducted five times per week with TMS at 10 pulses/sec , 120 % of motor threshold , 3000 pulses/session , for 4 - 6 weeks . Primary outcome was the symptom score change as assessed at week 4 with the Montgomery-Asberg Depression Rating Scale ( MADRS ) . Secondary outcomes included changes on the 17- and 24-item Hamilton Depression Rating Scale ( HAMD ) and response and remission rates with the MADRS and HAMD . RESULTS Active TMS was significantly superior to sham TMS on the MADRS at week 4 ( with a post hoc correction for ine quality in symptom severity between groups at baseline ) , as well as on the HAMD17 and HAMD24 scales at weeks 4 and 6 . Response rates were significantly higher with active TMS on all three scales at weeks 4 and 6 . Remission rates were approximately twofold higher with active TMS at week 6 and significant on the MADRS and HAMD24 scales ( but not the HAMD17 scale ) . Active TMS was well tolerated with a low dropout rate for adverse events ( 4.5 % ) that were generally mild and limited to transient scalp discomfort or pain . CONCLUSIONS Transcranial magnetic stimulation was effective in treating major depression with minimal side effects reported . It offers clinicians a novel alternative for the treatment of this disorder BACKGROUND Post-traumatic stress disorder ( PTSD ) is a debilitating anxiety disorder induced by traumatic experiences . To date , psychotherapy and drug treatment achieve only partial success , indicating need for further development of treatment strategies . Recent research has found that impaired acquired fear extinction capability serves as an important factor at the pathogenesis of the disorder . Medial prefrontal cortex ( mPFC ) hypo-activity has been implicated in this extinction impairment , providing insight as to why some trauma exposed individuals will develop PTSD . OBJECTIVE To test whether fear extinction can be facilitated and therapeutic effect achieved by repeated mPFC deep transcranial magnetic stimulation ( DTMS ) of PTSD patients resistant to st and ard treatment . METHODS In a double-blind study , 30 PTSD patients were enrolled and r and omly assigned into 3 treatment groups : A ) DTMS after brief exposure to the traumatic event with the script-driven imagery procedure ; B ) DTMS after brief exposure to a non-traumatic event ; C ) sham stimulation after brief exposure to the traumatic event . RESULTS Significant improvement was demonstrated in the intrusive component of the CAPS scale in patients administered DTMS after exposure to the traumatic event script , while patients in the control groups showed no significant improvement . Similar trend was demonstrated in the Total-CAPS score as in the other rating scales . A significant reduction in the HR response to the traumatic script was evident in group A , further supporting the above results . CONCLUSIONS Combining brief script-driven exposure with DTMS can induce therapeutic effects in PTSD patients . A wide multi-center study is suggested to substantiate these findings . TRIAL REGISTRATION Clinical Trials.gov identifier : NCT00517400 OBJECTIVE Word-finding difficulty ( anomia ) is commonly observed in Alzheimer 's dementia ( AD ) . The aim of this study was to assess the effect of repetitive transcranial magnetic stimulation ( rTMS ) applied to the dorso-lateral prefrontal cortex ( dlPFC ) on picture naming in 24 probable AD patients with different degrees of cognitive decline . METHODS High-frequency rTMS was applied to the left and right dlPFC during object and action naming in AD patients . A sham stimulation was used as a control condition . RESULTS Whilst , as previously reported , stimulation to both the left and the right dlPFC improved action , but not object naming in the mild AD group ; an improved naming accuracy for both classes of stimuli was found in the moderate to severe group . CONCLUSIONS Repetitive transcranial magnetic stimulation applied to the dlPFC improves naming performance also in the advanced stages of AD . Moreover , in the severe group the effect is not specific for action naming , as in the case of the mild AD group . These findings suggest that rTMS can affect the intrinsic ability of the brain to restore or compensate for damaged function and may represent an useful new tool for cognitive rehabilitation Objective Several studies have suggested that repetitive transcranial magnetic stimulation ( rTMS ) of the right prefrontal cortex may be useful in the treatment of posttraumatic stress disorder ( PTSD ) . The aim of this study was to compare the effect of rTMS on the right prefrontal cortex with that of sham stimulation among patients with PTSD . Methods In total , 18 patients with PTSD were r and omly assigned to the 1-Hz low-frequency rTMS group or the sham group for 3 weeks . Primary efficacy measures were the Clinician-Administered PTSD Scale ( CAPS ) and its subscales , assessed at baseline and at 2 , 4 , and 8 weeks . Results All CAPS scores improved significantly over the study period . We found significant differences in the re-experiencing scores ( F=7.47 , p=0.004 ) and total scores ( F=6.45 , p=0.008 ) on the CAPS . The CAPS avoidance scores showed a trend toward significance ( F=2.74 , p=0.055 ) , but no significant differences in the CAPS hyperarousal scores were observed . Conclusion The present study showed low-frequency rTMS to be an effective and tolerable option for the treatment of PTSD . Trials using variable indices of rTMS to the right prefrontal cortex and explorations of the differences in the effects on specific symptom clusters may be promising avenues of research regarding the use of rTMS for PTSD OBJECTIVE We aim ed to investigate the efficacy of 20 Hz repetitive transcranial magnetic stimulation ( rTMS ) of either right or left dorsolateral prefrontal cortex ( DLPFC ) as compared to sham rTMS for the relief of posttraumatic stress disorder (PTSD)-associated symptoms . METHOD In this double-blind , placebo-controlled phase II trial conducted between October 2005 and July 2008 , 30 patients with DSM-IV-diagnosed PTSD were r and omly assigned to receive 1 of the following treatments : active 20 Hz rTMS of the right DLPFC , active 20 Hz rTMS of the left DLPFC , or sham rTMS . Treatments were administered in 10 daily sessions over 2 weeks . A blinded rater assessed severity of core PTSD symptoms , depression , and anxiety before , during , and after completion of the treatment protocol . In addition , a battery of neuropsychological tests was measured before and after treatment . RESULTS Results show that both active conditions-20 Hz rTMS of left and right DLPFC-induced a significant decrease in PTSD symptoms as indexed by the PTSD Checklist and Treatment Outcome PTSD Scale ; however , right rTMS induced a larger effect as compared to left rTMS . In addition , there was a significant improvement of mood after left rTMS and a significant reduction of anxiety following right rTMS .  Improvements in PTSD symptoms were long lasting ; effects were still significant at the 3-month follow-up . Finally , neuropsychological evaluation showed that active 20 Hz rTMS is not associated with cognitive worsening and is safe for use in patients with PTSD . CONCLUSIONS These results support the notion that modulation of prefrontal cortex can alleviate the core symptoms of PTSD and suggest that high-frequency rTMS of right DLPFC might be the optimal treatment strategy BACKGROUND Repetitive transcranial magnetic stimulation ( TMS ) therapy can modulate pathological neural network functional connectivity in major depressive disorder ( MDD ) . Posttraumatic stress disorder is often comorbid with MDD , and symptoms of both disorders can be alleviated with TMS therapy . This is the first study to evaluate TMS-associated changes in connectivity in patients with comorbid posttraumatic stress disorder and MDD . METHODS Resting-state functional connectivity magnetic resonance imaging was acquired before and after  TMS therapy in 33 adult out patients in a prospect i ve open trial . TMS at 5 Hz was delivered , in up to 40 daily sessions , to the left dorsolateral prefrontal cortex . Analyses used a priori seeds relevant to TMS , posttraumatic stress disorder , or MDD ( subgenual anterior cingulate cortex [ sgACC ] , left dorsolateral prefrontal cortex , hippocampus , and basolateral amygdala ) to identify imaging predictors of response and to evaluate clinical ly relevant changes in connectivity after TMS , followed by leave-one-out cross-validation . Imaging results were explored 
    Output:
    
RESULTS Among anxiety and trauma-related disorders , TMS has been most widely studied as a treatment for PTSD .
Our meta- analysis suggests that TMS may be an effective treatment for GAD and PTSD