Changes in Trauma-based Intrusive Memory Characteristics Associated with Repetitive Transcranial Magnetic Stimulation (rTMS) for Depression: A Daily Diary Study

TL;DR

This study found that rTMS treatment for depression also reduces trauma-related intrusive memories and PTSD symptoms.

Contribution

The study is the first to use daily diary sampling in an inpatient setting to assess rTMS effects on intrusive memories.

Findings

Intrusive memory frequency and characteristics decreased non-linearly during rTMS treatment.

Large effect sizes were observed for traumatic stress, re-experiencing, and depression symptoms.

Reliable change was most common in traumatic stress and mental health measures.

Abstract

The present study investigated whether repetitive transcranial magnetic stimulation (rTMS) for depression reduced trauma-based intrusive memory frequency and associated pathological characteristics such as intensity and distress. Traumatic stress symptoms and general psychopathology outcomes were also investigated. Inpatients at a psychiatric hospital (N = 25) referred for 20-sessions of rTMS for depression completed daily ratings of trauma-related intrusive memory frequency and characteristics. Linear mixed models and repeated measures t-tests were used to analyze the course of change for intrusive memories. Effect sizes and reliable change were also analyzed. Non-linear decreases for intrusive memory frequency and associated characteristics were reported over the course of treatment, with the changes from Days 0 to 7 being sustained at Day 20. Large effect sizes were reported for measures of traumatic stress, and re-experiencing, depression, and stress symptoms. Reliable change was most commonly indicated for measures of traumatic stress and general mental health. Limitations of the study include the lack of a control group and small sample size. To the best of our knowledge, this study is the first to use a within-subject daily-sampling design to monitor intrusive memories, in an inpatient setting, within the context of rTMS treatment. Routine rTMS for depression appears beneficial for reducing trauma-based intrusive memories as well as PTSD symptoms more generally. The present study demonstrates clinical viability of extending routine rTMS protocols used for depression to trauma-based intrusive memories and associated symptomatology.

The online version contains supplementary material available at 10.1007/s11126-025-10156-4.

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