EC Clinical and Medical Case Reports

Case Report Volume 8 Issue 12 - 2025

rTMS for Recurrent Major Depressive Disorder and Generalized Anxiety Disorder Comorbid with Thalamic Pain Syndrome: A Case Report

Vipul Reddy1*, Harrison McDaniel1,2, Aarush Katta1,3, Hedy Bian1,4, Mark Odron1, Sarayu Snehansh1,5, Kavya Mohankumar1, Charles Vigilia1, Kenneth Blum6-11, David Baron12, Rajendra D Badgaiyan13 and Keerthy Sunder1,6,14

1Division of Clinical Neuromodulation Research, Karma Doctors, Palm Springs, CA, USA

2Palm Desert High School, Palm Desert, CA, USA

3Chaparral High School, Temecula, CA, USA

4University of California, Los Angeles, CA, USA

5Gretchen Whitney High School, Cerritos, CA, USA

6Sunder Foundation, Palm Springs, CA, USA

7Western University Health Science Centers, Pomona, CA, USA

8Department of Psychiatry, University of Vermont, Burlington, VT, USA

9Institute of Psychology, Eotvos Loránd University, Budapest, Hungary

10Department of Psychiatry, Wright State University Boonshoft School of Medicine, Dayton, OH, USA

11Centre for Genomics and Applied Gene Technology, Institute of Integrative Omics and Applied Biotechnology, Nonakuri, Purba Medinipur, West Bengal, India

12Department of Psychiatry, Stanford University School of Medicine, Palo Alto, CA, USA

13Department of Psychiatry, Mt. Sinai University School of Medicine, New York City, NY, USA

14Department of Psychiatry, University of California: UC Riverside School of Medicine, CA, USA

*Corresponding Author: Vipul Reddy, Division of Clinical Neuromodulation Research, Karma Doctors, Palm Springs, CA, USA.
Received: September 16, 2025; Published: November 11, 2025



This paper examines the utilization of repetitive transcranial magnetic stimulation (rTMS) to treat recurrent Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD) in a patient comorbid with Thalamic Pain Syndrome (TPS), a type of central post-stroke pain. TPS is a consequence of thalamic injury and is characterized by chronic neuropathic pain that is insufficiently responsive to pharmacological treatment. Symptoms of TPS can increase the risk of MDD and GAD, negatively impacting quality of life. Repetitive Transcranial Magnetic Stimulation (rTMS) is an FDA-approved modality for treatment-resistant major depressive disorder (MDD) and has shown promise for off-label treatment of anxiety disorders. Quantitative psychometric questionnaires were administered weekly via PHQ-9 (Patient Health Questionnaire-9) and GAD-7 (Generalized Anxiety Disorder-7), revealing symptom reductions of 95.5% and 88.2%, respectively. An improvement was noted in neuropathic pain symptoms, as indicated by a 10.2% reduction in Neuropathic Pain Scale (NPS) scores. The patient reported improved quality of life, as demonstrated by an increased ability to cope with TPS symptoms. Furthermore, the patient was no longer suicidal after completing 36 rTMS treatments. Further large-scale, randomized, and blinded trials are recommended to validate the efficacy of rTMS as a modality for complex neuropsychiatric and pain-related comorbidities.

 Keywords: Repetitive Transcranial Magnetic Stimulation (rTMS); Dorsolateral Prefrontal Cortex (DLPFC); Neuromodulation; MDD (Major Depressive Disorder); PHQ-9 (Patient Health Questionnaire-9); GAD-7 (Generalized Anxiety Disorder-7 Item Scale); Motor Threshold (MT); Thalamic Pain Syndrome (TPS); Neuropathic Pain Scale (NPS)

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Vipul Reddy., et al. “rTMS for Recurrent Major Depressive Disorder and Generalized Anxiety Disorder Comorbid with Thalamic Pain Syndrome: A Case Report”. EC Clinical and Medical Case Reports  8.12 (2025): 01-09.

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