Improvements in emotion regulation following repetitive transcranial magnetic stimulation for generalized anxiety disorder

J Anxiety Disord. 2016 Oct;43:1-7. doi: 10.1016/j.janxdis.2016.07.002. Epub 2016 Jul 9.


Generalized anxiety disorder (GAD) is characterized by emotion regulation difficulties, which are associated with abnormalities in neural circuits encompassing fronto-limbic regions including the dorsolateral prefrontal cortex (DLPFC). The aim of this study was to determine whether DLPFC neuromodulation improves emotion regulation in patients with GAD. This is a secondary analysis from a randomized-controlled trial comparing 30 sessions of low-frequency right-sided active (n=13) versus sham (n=12, sham coil) repetitive transcranial magnetic stimulation (rTMS) at the right DLPFC in patients with GAD. Results indicated statistically significant improvements in self-reported emotion regulation difficulties at posttreatment and 3-month follow-up in the active group only. Improvements were found primarily in the domains of goal-directed behaviors and impulse control and were significantly associated with a global clinician rating of improvement. These preliminary results support rTMS as a treatment for GAD and suggest improved emotion regulation as a possible mechanism of change.

Keywords: Anxiety; Emotion regulation; Neuromodulation; Randomized-controlled trial.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anxiety Disorders / psychology
  • Anxiety Disorders / therapy*
  • Emotions*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Self Report
  • Transcranial Magnetic Stimulation*
  • Treatment Outcome