Written exposure therapy augmented with transcranial direct current stimulation for posttraumatic stress disorder: A pilot randomized clinical trial

Published October 18, 2026. Both groups improved. Active stimulation was associated with an earlier reduction in self-reported PTSD symptoms during the five-session treatment, but it did not produce better clinician-rated or self-reported outcomes than sham stimulation one month later. This small pilot identifies a question for a larger trial, not an established advantage.

Straud CL, Buccellato KH, Martinez M, Young‐McCaughan S, Moring JC, Barron S, Carreno FR, Lodge D, Morilak DA, Marx BP, Sloan DM, Peterson AL.
Journal of Traumatic Stress · Publication date: 2026-10-18
Added to site: 2026-10-20
DOI: 10.1002/jts.70132

First published online October 18, 2026. Added to Neurofeedback.com October 20, 2026.

Modalities

tDCS, Written exposure therapy, Noninvasive brain stimulation

Clinical focus

Posttraumatic stress disorder, Adjunctive psychotherapy, Early response

Population

Treatment-seeking adults aged 18 to 65 with DSM-5 PTSD recruited from military, veteran and community settings

Sample

25 randomized: 12 active tDCS plus written exposure therapy and 13 sham tDCS plus written exposure therapy; 24 completed all five treatment sessions and 20 completed the one-month clinician assessment

Intervention / method

Five weekly 30-minute written exposure therapy sessions with concurrent 2.0 mA active tDCS or matched sham stimulation. The anode was placed over the left dorsolateral prefrontal cortex and the cathode over the right.

Comparator

Active tDCS plus written exposure therapy versus sham tDCS plus the same written exposure therapy

Clinician summary

The PCL-5 trajectory showed a group-by-visit interaction (p = .010), with a session-four active-versus-sham difference of 12.25 points (p = .039, d = 0.85). One-month CAPS-5 and PCL-5 group comparisons were nonsignificant (p values .573 to .619), and remission did not differ. Related adverse events were descriptively more frequent with active stimulation: 27 versus 12 events, and 75.0% versus 46.2% of participants reporting at least one event. No serious or unexpected related events were reported.

How to interpret the findings

This was a small pilot with limited statistical power, a one-month follow-up and a predominantly White, relatively advantaged Western sample. Treatment fidelity was not evaluated with rigorous independent ratings. The early trajectory signal was secondary and requires replication, and the study was not large enough to characterize uncommon harms.

Equipment and disclosures

Soterix 1x1 mini-CT clinical trial device (Soterix Medical Inc.), explicitly identified by the study. This site summary does not imply endorsement or BrainMaster involvement.

Supported by a University of Texas San Antonio Center for Biomedical Neurosciences intramural program award; the sponsor had no role in the study. Brian P. Marx and Denise M. Sloan reported American Psychological Association royalties for the written exposure therapy manual. No other conflicts were reported. The authors disclosed AI assistance for editing and readability. No indexed correction, retraction or concern relation appeared in the retained Crossref record; this is a bounded check. AI-assisted review.

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