Stimulation intensity of 100% of the individual resting motor threshold in bursts of three pulses at a frequency of 50 Hz every 200 ms on top of a 5Hz carrier wave. Pulse delivery is over 2 s and repeated every 10 s, 20 times in succession, for a total of 600 pulses delivered in 3.33 minutes.
Delivered over vmPFC, as determined by position Fpz of the international 10-20 EEG electrode system.

Stimulation intensity of 100% of the individual resting motor threshold in bursts of three pulses at a frequency of 50 Hz every 200 ms on top of a 5Hz carrier wave. Pulse delivery is over 2 s and repeated every 10 s, 20 times in succession, for a total of 600 pulses delivered in 3.33 minutes.
Delivered over vertex, as determined by position Cz of the international 10-20 EEG electrode system.

Arachnophobia

Phobia

iTBS delivered to vmPFC for active treatment of spider phobia.

Intermittent Theta Burst Stimulation (iTBS), Ventromedial Prefrontal Cortex (vmPFC)

iTBS delivered to vertex for placebo treatment of spider phobia.

Intermittent Theta Burst Stimulation (iTBS), vertex

University of California, Los Angeles

TMS and Exposure Therapy

Transcranial Magnetic Stimulation (TMS) in Conjunction With Exposure Therapy for the Treatment of Spider Phobia

The difference between the number of steps completed during the pre- and post-treatment behavioral approach tests.

The difference between the number of skin conductance peaks measured during the pre- and post-treatment behavioral approach tests.

Changes in scores on questionnaires regarding distress around spiders (Klorman spider phobia questionnaire). Scored on a scale of 0-31, with higher numbers associated with greater subjective fear of spiders. No subscales reported

Changes in scores on questionnaires regarding distress around spiders (Syzmanski Fear of Spiders Questionnaire). 18 items each scored on a scale of 1-7 (total score ranging 18-126), with higher numbers associated with greater subjective fear of spiders. No subscales reported

Change in heart rate variability at each step of BAT

The difference between the change in skin conductance measured during the pre- and post-treatment behavioral approach tests.

Changes in subjective distress (reported 0-100) reported at each step during the behavioral approach test

The number of exposure therapy sessions attended by each participant

The number of TMS sessions attended by each participant

Michael K Leuchter

Medical Student, David Geffen School of Medicine

Participants will be randomly assigned to either the study treatment (iTBS stimulation to the ventromedial prefrontal cortex) or control treatment (iTBS stimulation to the vertex). Treatments will occur immediately following exposure therapy (both groups will undergo identical exposure therapy), and groups will receive iTBS to the same site for all three treatments

Assignment will be performed randomly and tracked by clinical staff involved with the TMS treatment itself, and research staff assessing outcomes and analyzing data will be blinded to groups until after analysis is complete.

spider bites/seizures

TMS and Exposure Therapy

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