Don't Hurt Me No More: State-dependent Transcranial Magnetic Stimulation for the treatment of specific phobia

Specific phobia (SP) is the most prevalent anxiety disorder, with especially high prevalence in women (6-12%). SP is characterized by an excessive, irrational fear of a specific object or situation, which is either avoided at all cost, or endured with great distress, interfering with work and quality of life. The combination of psychotherapy and pharmacotherapy are generally regarded as first-line treatment. However, about 25% of patients respond poorly to treatment and show a high risk of chronicity, or experience a return of fear. Estimates of direct and indirect annual costs for SP are high (Bajbouj and Padberg, 2014). Therefore, developing and implementing new effective treatments for such a highly debilitating disorder is urgently needed. Increasing evidence suggests that targeted modulation of neural networks by non-invasive brain stimulation (NIBS) might represent a further treatment option (Bajbouj and Padberg, 2014). However, very few studies have tested the efficacy of NIBS in the treatment of SP.