Clinical improvement in patients with borderline personality disorder after treatment with repetitive transcranial magnetic stimulation: preliminary results

Abstract

Objective:Current treatment of borderline personality disorder (BPD) consists of psychotherapy and pharmacological interventions. However, the use of repetitive transcranial magnetic stimulation (rTMS) could be beneficial to improve some BPD symptoms. The objective of this study was to evaluate clinical improvement in patients with BPD after application of rTMS over the right or left dorsolateral prefrontal cortex (DLPFC).Method:Twenty-nine patients with BPD from the National Institute of Psychiatry, Mexico, were randomized in two groups to receive 15 sessions of rTMS applied over the right (1 Hz, n=15) or left (5 Hz, n=14) DLPFC. Improvement was measured by the Clinical Global Impression Scale for BPD (CGI-BPD), Borderline Evaluation of Severity Over Time (BEST), Beck Depression Inventory (BDI), Hamilton Anxiety Rating Scale (HAM-A), and Barratt Impulsiveness Scale (BIS).Results:Intragroup comparison showed significant (p < 0.05) reductions in every psychopathologic domain of the CGI-BPD and in the total scores of all scales in both groups.Conclusions:Both protocols produced global improvement in severity and symptoms of BPD, particularly in impulsiveness, affective instability, and anger. Further studies are warranted to explore the therapeutic effect of rTMS in BPD.Clinical trial registration:NCT02273674.

Repetitive Transcranial Magnetic Stimulation Treating Impulsivity in Borderline Personality Disorder and Attention Deficit/Hyperactivity Disorder

“…After excluding duplicates and nonrelevant contributions (e.g. theoretical articles), five studies were included in the review [70][71][72][73][74].…”

“…The last study is from Reyes-López et al [74]. They stimulated 29 BPD patients divided into two groups with two stimulation designs.…”

“…Another question was raised by the study by Reyes-López et al [74]. They used low-frequency rTMS in the right DLPFC and found similar effects as after high-frequency rTMS over the same area.…”

Transcranial magnetic stimulation in stroke rehabilitation

“…Patients with depression seem to have reduced activity in the left prefrontal cortex, therefore, high frequency rTMS has been used to excite this area (19). In borderline personality disorder, rTMS applied over the right (1 Hz) or left (5 Hz) dorsolateral prefrontal cortex improve some symptoms, such as impulsiveness, affective instability, and anger (20). Continuous theta burst transcranial magnetic stimulation of the lateral cerebellum modulates motor cortical excitability and improves symptoms in movement and cognitive disorders (21).…”

Avaliação dos efeitos da estimulação magnética transcraniana repetitiva sobre a ansiedade em pacientes com lesão axonial difusa traumática

“…A EMTr já é estabelecida como alternativa não invasiva de estimulação cerebral com estudos demonstrando ser uma ferramenta válida para medição das alterações plásticas do córtex cerebral, tem sido sugerida para o tratamento de diversas doenças neurológicas e psiquiátricas (5,6,146), principalmente para o tratamento da depressão (164,166,172,173,176,182,184), o que favoreceu o embasamento da escolha do protocolo de intervenção da EMTr desta pesquisa. Os níveis de ansiedade moderado e grave encontrados em nossa amostra também pode ter influenciado em nossos resultados, se tivéssemos definido apenas pacientes em nível grave, poderíamos ter obtido efeito de melhora diferente.…”