We Stand on the Shoulders of Giants
The MeRT approach is an innovative and targeted treatment based on powerful third party research that has been published in the most prestigious scientific journals. Below you will find the peer-reviewed and published research regarding EEGs, rTMS, and MeRT that build the foundation of our approach to treatment of the brain.
Autism Studies
“A recent review was done, focused on published research studies using TMS to treat ASD between 2018 and 2023. These were systematically reviewed to study characteristics, specific parameters of TMS, localization techniques and stimulus targets, behavioral outcomes, and neuroimage biomarker changes. It was extensive and you can see the full study here:
“After TMS intervention, discernible enhancements across a spectrum of scales are evident in stereotyped behavior, repetitive behavior, and verbal social domains. A comprehensive review of literature spanning the last five years demonstrates the potential of TMS treatment for ASD in ameliorating the clinical core symptoms.
“Recent findings generally indicate that TMS has positive effects on stereotypical behavior, repetitive behavior, verbal and social aspects of ASD, leading to overall improvement across all scale scores post-intervention.
“Transcranial magnetic stimulation (TMS) is a promising, emerging tool for the study and potential treatment of ASD. Recent studies suggest that TMS measures provide rapid and noninvasive pathophysiological ASD biomarkers. Furthermore, repetitive TMS (rTMS) may represent a novel treatment strategy for reducing some of the core and associated ASD symptoms.
“While its true potential in ASD has yet to be delineated, TMS represents an innovative research tool and a novel, possibly transformative approach to the treatment of neurodevelopmental disorders.
“Repetitive TMS affords researchers to design specific stimulation protocols that can modulate neuroplasticity, and such neuroplasticity-based brain stimulation interventions look promising.”
“Existing evidence still indicates that aberrant neuroplasticity could play a critical role in the pathogenesis of ASD. Therefore, it can be postulated that it may be possible to attain optimal social and cognitive performance in ASD by stabilizing aberrant neuroplasticity. In this context, we discussed a novel mechanism-driven approach toward achieving such goal using rTMS. If successful, this information will not only help us better understand the brain mechanisms involved in ASD but also stimulate trials testing mechanism-driven novel brain stimulation treatment paradigms for ASD.”
“The results of our systematic review and meta-analysis data indicate that TMS may offer a promising and safe treatment option for pediatric and young adult patients with IC-ASD.”
“Several rTMS trials in ASD have shown marked improvements in motor symptomatology, attention and perceptual binding.
“Conclusion: rTMS is the first therapeutic attempt at ASD aimed at correcting some of its core pathology.”
“TMS is a non-invasive therapeutic intervention capable of modulating evoked and induced gamma oscillations and altering maladaptive behaviors83. Recent reviews of the literature suggest that TMS is safe and effective when used in ASD.”
“Our findings suggest that HF [high frequency] rTMS over the left parietal cortex might improve core deficits in low-functioning children with ASD.”
“Repetitive transcranial magnetic stimulation (rTMS) emerges as a useful therapy for autism spectrum disorder (ASD) clinically.”
“The results showed the hyper-variability in the resting-state networks of ASD patients, while three week rTMS treatment alleviates the hyper fluctuations occurring in the frontal-parietal and frontal-occipital connectivity and further contributes to the ameliorative ASD symptoms. In addition, the changes in variability network properties are closely correlated with clinical scores, which further serve as potential predictors to reliably track the long-term rTMS efficacy for ASD.Significance.The findings consistently demonstrated that the temporal variability of time-varying networks of ASD patients could be modulated by rTMS, and related variability properties also help predict follow-up rTMS efficacy, which provides the potential for formulating individualized treatment strategies for ASD”
“The findings of this study demonstrate that high-frequency rTMS over the parietal lobe is potentially an effective strategy to improve core symptoms by enhancing long-range connectivity reorganization in ASD.”
“rTMS provides changes in connectivity and behavior, suggesting its potential use as a viable treatment option for ASD individuals.”
“Our results suggest that rTMS, particularly after 18 sessions, facilitates cognitive control, attention and target stimuli recognition by improving discrimination between task-relevant and task-irrelevant illusory figures in an oddball test. The noted improvement in executive functions of behavioral performance monitoring further suggests that TMS has the potential to target core features of ASD.”
“There was a statistically significant clinical improvement in patients receiving active TMS comparing baseline Childhood Autism Rating Scale (CARS) assessment and after treatment.
“There was significant difference in improvement between the two groups according to eye contact. There was significant improvement in response to examiner.
“There was significant difference in improvement between the two groups according to active expressive language.
“Conclusion: Repetitive transcranial magnetic stimulation (rTMS) over left inferior frontal gyrus may be a safe and effective way of improving language of ASD. The joint application of rTMS and standard language therapy may lead to more rapid improvement in the language progress of children with ASD.”
“These findings supported our hypothesis by demonstration of positive effects of combined rTMS neurotherapy in active treatment group as compared to the waitlist group, as the rTMS group showed significant improvements in behavioral and functional outcomes as compared to the waitlist group.”
“Conclusion: This study presents evidence on the efficacy and safety of α-rTMS in improving ASD symptoms, quality of life and comorbid sleep troubles in children. However, these findings should be interpreted as preliminary pending the presentation of double-blind, randomised clinical trials.”
“Given our understanding of the EEG and the consistent abnormalities in the electrophysiology of children with ASD, we would suggest that MRT [MeRT] is an appropriate therapeutic option to further pursue. The existing literature in depression and posttraumatic stress disorder in addition to preliminary studies in children with ASD all support its potential impact as a therapeutic option.”
“Following 5 weeks of EEG-EKG guided transmagnetic stimulation, significant changes in symptom severity and EEG measures are reported for 28 children with autism spectrum disorder. … This suggests that EKG-EEG guided TMS may be effective at mitigating averse sensory misperceptions common in ASD.”
Depression Studies
TMS Should Be Considered as First-Line Treatment For Moderate to Severe Major Depressive Disorder, in Psychiatric News, October 2022. The article’s author, Richard A. Bermudes, reviewed a decade’s worth of studies on the effectiveness of TMS, and wrote this:
“As I read the [APA] guidelines recently and considered the number of new outcome studies conducted with TMS, I believe TMS should be considered, in addition to pharmacotherapy and psychotherapy, as a first-line treatment for patients with moderate to severe major depressive disorder.”
A retrospective chart review to assess the impact of alpha- guided transcranial magnetic stimulation on symptoms of PTSD and depression in active-duty special operations service members, 21 June 2024. “This data provides a demonstration of significant reduction in PTSD and depression symptoms and safety with the application of a-rTMS in active-duty special operations military personnel. Expansion of targeted neuromodulation programs could be impactful for military and civilian populations.”
Transcranial magnetic stimulation (TMS) for major depression: a multisite, naturalistic, observational study of quality of life outcome measures in clinical practice, July 2013. This study found: “Conclusion: These data confirm that TMS is effective in the acute treatment of MDD in routine clinical practice settings. This symptom benefit is accompanied by statistically and clinically meaningful improvements in patient-reported QOL [quality of life] and functional status outcomes.”
Transcranial magnetic stimulation (TMS) for major depression: a multisite, naturalistic, observational study of acute treatment outcomes in clinical practice, Carpenter et al, 2012. This study found as its conclusion: “These data indicate that TMS is an effective treatment for those unable to benefit from initial antidepressant medication.”
A naturalistic study of the efficacy and acceptability of rTMS in treating major depressive disorder in Australian youth, June 30, 2024, found the following:
“Results: A 4–7-week course of rTMS significantly reduce symptoms of self-reported depression (42.5% response) and clinician-assessed depression (40.7% response). Both anxiety and stress significantly reduced across the course of rTMS treatment and significant improvements to QoL and self-reported cognition were observed. Reported side effects following rTMS in youth included a mild headache and fatigue.
“Conclusions: The findings of this naturalistic study suggest that an acute course of rTMS provided in private clinical settings is safe and effective – resulting in similar response rates in youth patients as reported in adult patients. In real world practice, rTMS proves to be a well-tolerated and highly effective intervention for MDD in youth, across diverse clinical settings.
“Implications and Contribution: The findings of this naturalistic study suggest that in real world practice, rTMS proves to be a well-tolerated and highly effective intervention for treating depression and anxiety in youth (17–25-year-olds), with additional benefits to cognitive symptoms of depression and overall well-being.”
Efficacy of repetitive transcranial magnetic stimulation in treatment-resistant depression: the evidence thus far, August 2019. This found: “rTMS is rapidly gaining popularity as a treatment modality for depression. There is growing evidence to support its use in patients with depression as a monotherapy or as adjunct with pharmacotherapy. Additionally, rTMS has been found to be safe and effective in pregnant patients and elderly patients…”
Use of Transcranial Magnetic Stimulation for Depression, May 2019, stated: “The clinical efficacy of TMS as an antidepressant has been well established. TMS is an innovative and promising treatment modality for patients with TRD [treatment-resistent depression].”
Experimental depression treatment is nearly 80% effective in controlled study, October 28, 2021: “In a double-blind controlled study, high doses of magnetic brain stimulation, given on an accelerated timeline and individually targeted, caused remission in 79% of trial participants with severe depression.
“A new type of magnetic brain stimulation brought rapid remission to almost 80% of participants with severe depression in a study conducted at the Stanford University School of Medicine.
Stanford Neuromodulation Therapy (SNT): A Double-Blind Randomized Controlled Trial, Oct 2021: “Major depressive disorder is the leading cause of disability worldwide, and approximately 50% of patients meet criteria for treatment-resistant depression. Repetitive transcranial magnetic stimulation (rTMS), a brain stimulation treatment approved by the U.S. Food and Drug Administration (FDA) for treatment-resistant depression, targets the left dorsolateral prefrontal cortex (DLPFC), a key area in neural circuitry underlying depressive symptoms that has been shown to be hypoactive in major depressive disorder. Contemporary FDA-approved protocols for stimulation of the left DLPFC are limited by the long duration of treatment course (6 weeks) and have been only modestly effective, inducing remission after 4–6 weeks of treatment in ∼17% of patients who have not shown response to three prior antidepressant treatments.”
PTSD Studies
A retrospective chart review to assess the impact of alpha- guided transcranial magnetic stimulation on symptoms of PTSD and depression in active-duty special operations service members, 21 June 2024. “This data provides a demonstration of significant reduction in PTSD and depression symptoms and safety with the application of a-rTMS in active-duty special operations military personnel. Expansion of targeted neuromodulation programs could be impactful for military and civilian populations.”
Synchronized transcranial magnetic stimulation for posttraumatic stress disorder and comorbid major depression “All participants demonstrated significant reductions in PTSD and MDD symptoms (all p < .001). As expected, there were significant reductions in symptoms in both treatment groups, but active stimulation did provide greater reductions in count of PTSD moderate-to-severe symptoms.”
Magnetic Resonance Therapy Improve Clinical Phenotype and EEG Alpha Power in Post-traumatic Stress Disorder, in Trauma Monthly, November 2015. ‘This study suggests that non-invasive neuromodulation magnetic resonance therapy may lead clinical improvements as well as a trend toward normalization of EEG pathophysiology in PTSD.”
Magnetic E-Resonant Therapy Alleviates Combat Related Post-traumatic Stress Disorder, in Aerospace Medical Association, March 2017. “Our preliminary results suggest that transcranial MeRT may provide an alternate method to help veterans suffering from PTSD.”
Individualized Electromagnetic Treatment in Posttraumatic Stress Disorder: a Randomized, Double-blind, Sham-controlled Trial, Poster Accepted, Taghva, et al. “This double-blind, randomized, controlled trial shows that transcranial magnetic therapy based on individualized frequencies derived from EEG/EKG is an effective therapy for PTSD in improving overall symptoms and quality of sleep.”
How Electric Therapy Is Curing Navy SEALs of PTSD, Jan 2019. “Hundreds of vets have tried out an experimental new treatment that could change how the world addresses mental disorders.” And, “All said that they saw big improvements after a course of therapy that ran five days a week for about four weeks.”
EEG_EKG Guided TMS in veterans with PTSD_Randomized double-blinded pilot study. “Following 2 weeks of EEG-EKG guided transmagnetic stimulation, significant changes in symptom severity and EEG measures are reported for 80 retired military veterans with post-traumatic stress disorder. Patients had greatest comparative reductions in PCL-M subscales VII “avoid situation indicator” XII “short future indicator” and XIII “trouble falling or staying asleep indicator”. The improvement in sleep was confirmed for treated vs sham group in PSQI-A, and, may suggest correlation between sleep disorder and PTSD symptoms. Of the 37 patients who had suicidal ideation by HAM-D, 29 patients denied ideation by 4 weeks. No patient worsened in clinical PTSD symptoms after receiving therapy. “
Low-frequency, Repetitive Transcranial Magnetic Stimulation for the Treatment of Patients with Posttraumatic Stress Disorder: a Double-blind, Sham-controlled Study, Nam et al, 2013. “The present study showed low-frequency rTMS to be an effective and tolerable option for the treatment of PTSD. Trials using variable indices of rTMS to the right prefrontal cortex and explorations of the differences in the effects on specific symptom clusters may be promising avenues of research regarding the use of rTMS for PTSD.
Head Injuries, TBI Treatment Studies
The use of repetitive transcranial magnetic stimulation (rTMS) following traumatic brain injury (TBI): A scoping review: “Evidence suggests that rTMS has the potential to be an efficacious therapeutic intervention for multiple symptoms after TBI, including depression, dizziness, central pain, and visual neglect. “
Neuromodulatory Interventions for Traumatic Brain Injury: In this special issue of the Journal of Head Trauma Rehabilitation, we share with readers some of the latest advancements in neuromodulation specific to TBI, while providing the framework to further our understanding of how and why functional skills are likely improved. While neuromodulatory interventions can play a critical role in functional recovery for those with TBI, the heterogenous nature of TBI means that clinical implementation of neuromodulation will require understanding, at the individual and group levels, of how, when, and where to alter brain activity to support sustained recovery of sensory and higher order functions.
The role of transcranial magnetic stimulation in treating depression after traumatic brain injury: “This study suggests that rTMS is a potential treatment option for depression following TBI. Both 15 to 16 session and 30 to 38 session cohorts showed significant decreases in depression as measured by PHQ-9 following rTMS treatment. These findings support the use of rTMS in post-concussion depression treatment and highlight the need for more research on rTMS therapy following TBI.
Randomized trial of rTMS in traumatic brain injury: improved subjective neurobehavioral symptoms and increases in EEG delta activity: “Subjective measures of depression, sleep dysfunction, post-concussive symptoms (PCS), and executive function showed significant improvement with stimulation, retaining improved levels at two-week follow-up. EEG delta power exhibited elevation one week after stimulation cessation.”
Neural mechanisms of emotional health in traumatic brain injury patients undergoing rTMS treatment: “Our findings uncover the neural mechanisms underlying the improvement in emotional well-being in TBI due to application of neuromodulation. The main effect of rTMS is to reduce emotional disorders and hence consequently it may improve cognitive and executive functions.”
Low frequency transcranial magnetic stimulation for cognitive recovery after traumatic brain injury: A case report: “Our results are consistent with studies showing improved cognitive functioning in TBI following a unilateral or bilateral rTMS protocol that used low frequency rTMS over the right DLPFC. Therefore, this stimulation site may be promising for improving cognitive recovery in TBI, especially when combined with cognitive rehabilitation.”
Repetitive Transcranial Magnetic Stimulation for Treatment of Depression in a Patient With Severe Traumatic Brain Injury: “Case Report: A 37-year-old male with history of anxiety and bipolar depression incurred a TBI after a 60-foot fall. After his physical recovery, the patient had refractory depression. Eight months after the TBI event, he underwent a 6-week course of rTMS treatment and had a 70.8% improvement in mood symptoms by the end of the therapy as indicated by the Patient Health Questionnaire-9, transitioning from severe to mild depression according to the scoring system. Clinical correlation during the months following conclusion of rTMS therapy showed no signs of remission or adverse side effects. The patient remains stable and lives independently 1 year after treatment with mood-stabilizing medications.
“Conclusion: This case provides evidence for successful treatment of refractory depressive symptoms after severe TBI with the addition of rTMS to psychotherapy and mood-stabilizing medications, supporting the safety and tolerability of this novel therapeutic approach. Further studies are needed to validate the contribution of rTMS for management of mood symptoms in patients with TBI.”
MeRT Ongoing Clinical Trials with the Department of Defense for PTSD, Post-Concussive Disorders, and TBI
PTSD Trials – Currently Military Specific
Congressional Approval (This is congressional approval for the use of MeRT® treatment for TBI, Post-Concussive Disorder, and PTSD)
Anxiety Treatment Studies
Transcranial magnetic stimulation for the treatment of anxiety disorder: “We observed, in general, that most of the studies found satisfactory results with the use of rTMS in Anxiety Disorders and Anxiety as comorbidity.
“In the studies on Anxiety Disorders, it was observed that three papers reported a sustained effect of response on the improvement of anxious symptoms, one paper reported improvement of symptoms, although this response did not sustain in the long term and one paper reported that there was no significant improvement.
“The papers on Anxious Symptoms showed that most of the studies obtained the sustained effect of response on the anxiety symptoms observed in 21 studies.”
Transcranial magnetic stimulation in anxiety and trauma-related disorders: A systematic review and meta-analysis: “Conclusions: Our meta-analysis suggests that TMS may be an effective treatment for GAD and PTSD.
- We reviewed TMS as a treatment for anxiety disorders and PTSD.
- TMS presented large effect sizes as a treatment for PTSD and GAD.
- Follow-up studies in GAD showed improvement of patients after TMS.”
Repetitive Transcranial Magnetic Stimulation (rTMS) in Treatment Resistant Depression: Retrospective Data Analysis from Clinical Practice: “Baseline depression and anxiety scores were in the moderate to severe range (see Table 2). There was a statistically significant improvement on all measures after the rTMS treatment, with small to medium effect sizes.
“The results show that rTMS significantly improved all measures of depression and anxiety. Response and remission rates for depression were 34.6% and 20.6% for the HAM-D; 10% and 28.6% for the PHQ-9; 31% and 31.8% for the CGI; and for anxiety they were and 24.6% and 28.8% (GAD-7). Effect sizes were medium, expect for PHQ-9 which was low. Reliable change analysis of GAD-7 and PHQ-9 indicated greater improvement in self-reported anxiety than depression. The reliable change in anxiety was similar to that which has been achieved through a national programme of psychotherapy for moderate to severe anxiety ( Richards & Borglin, 2011; Griffiths & Griffiths, 2015). The study’s findings support published rTMS results showing a positive impact on depression and anxiety.”
Stroke Recovery
“This study was conducted to determine the possibility of inducing cognitive recovery by using rTMS treatment for patients with PSCI that persisted for more than 6 months, despite intensive rehabilitation treatment for cognition. The results indicated a cognition-enhancing effect in the patients via increments in the IQ, AVLT, CFT, and MQ scores just after 2 weeks of rTMS completion. After 3 months, the increments in the AVLT, CFT, and MQ scores were sustained, and the IQ was increased with marginal significance.”
“In summary, we have obtained significant results that suggest that high-frequency rTMS treatment for ipsilateral DLPFC may exert beneficial effects on the short- and long-term improvement of cognitive function in chronic PSCI patients by reducing inflammation in the brain and altering the functional connectivity of several brain regions.”
Parkinson’s
Deep Brain Stimulation in Neurological and Psychiatric Disorders, Coenen VA, et al, 2015.
Neuromodulation Studies and Reports
Studies on EEG Findings
EEG Changes Associated with Autistic Spectrum Disorders, Boutros et al, 2015.
The Quantitative Electroencephalogram and the Low-Resolution Electrical Tomographic Analysis in Posttraumatic Stress Disorder, Todder et al, 2012
EEG Alpha Rhythm Frequency and Intelligence in Normal Adults, Anokhin & Vogel, 1996.
Traumatic Brain Injury – An EEG Point of View, lanof and Anghinah, 2017
