Panic disorder with agoraphobia: Repetitive transcranial magnetic stimulation (rTMS) treatment and evaluation of regional brain metabolism (18FDG PET). Case report
Abstract
44 years old woman diagnosed as a panic disorder with agoraphobia was treated with high-frequency repetitive transcranial magnetic stimulation (rTMS) for 2 weeks. Regional brain metabolism (18FDG PET) was evaluated before and after the rTMS treatment.
Dorsolateral prefrontal cortex was chosen as a site of stimulation with 20Hz, at 80% MT, with a total number of impulses equaling 18000. There was an increase of brain metabolism in comparison with healthy controls in frontal lobe regions bilaterally, in the right upper temporal lobe, middle temporal and parietal lobe bilaterally and in the left insula.
After the rTMS treatment we found an increase of metabolism in the right paracentral gyrus and also in the left medial frontal gyrus. During the treatment with rTMS there was an improvement according to the psychopathology rating scales.
There was a short-term effect of augmentation treatment with rTMS found. After the following 3 weeks the symptoms were worsened