Anotace:
We present the results of a case series study of individually navigated repetitive transcranial magnetic stimulation (rTMS) in four patients with borderline personality disorder (BPD). Patients and methods: Four patients with BPD performed a Go/ NoGo task during functional MRI (fMRI) designed for observing behavioural inhibition neural correlates. The site within the right dorsolateral prefrontal cortex with the largest difference in BOLD signal between the NoGo and Go conditions was assigned as a target for rTMS in each patient. Four patients underwent 15 sessions of individually navigated 10-Hz rTMS treatment at 110% of their individual resting motor threshold for 3 weeks (one session per working day). One session contained 1,500 pulses delivered in 15 trains by 10 s, leading to a total of 22,500 pulses during the treatment. Results: The treatment was very well tolerated without any serious side effects. After the treatment, the patients reported that they felt better self-control of their emotions, especially anger; that their urges for self-harm and suicidal thoughts decreased or disappeared; and that their derealisation/ depersonalisation episodes disappeared. Patients also showed less depression symptoms after the treatment.