Repetitive transcranial magnetic stimulation in patients with borderline personality disorder: A systematic review. (October 2021) - Konstantinou, Gerasimos N.
Highlights: The neuromodulatory effects of rTMS on the underlying neural circuitry involved in symptoms of BPD suggest that it could be a potential treatment option. Double-blind randomized controlled studies are necessary to help establish efficacy and the best cortical targets and stimulation protocols, and elucidate the effects of rTMS in the different symptoms in BPD. The combination of evidenced based psychotherapy with rTMS may be a future line of investigation that could potentially improve outcomes for this population. Abstract: The literature on the application of repetitive transcranial magnetic stimulation (rTMS) in Borderline Personality Disorder (BPD) is unclear, even though its neuromodulatory effects on underlying neural circuitry involved in BPD symptoms suggest that it could be a potential treatment option. We sought to review the evidence on rTMS as a treatment option in BPD. PubMed (for Medline database), Google Scholar, and Scopus were systematically searched following the PRISMA guidelines for studies of any design examining the application of the rTMS treatment in adult patients with precise and primary diagnosis of BPD written in the English language. The systematic review has been registered on PROSPERO (CRD42020215927). Forty one records were screened, and eight fulfilled inclusion criteria (total of 63 patients). The existing studies suggest that rTMS is a well-tolerated treatment in patients with BPD. Double-blind randomized controlled studies are necessary to help elucidate the effects of rTMS in the different symptoms in BPD and establish efficacy and the best cortical targets and stimulation protocols. Longitudinal studies that combine evidenced based psychotherapy with rTMS may be a future line of investigation that could potentially improve outcomes for this population.