Inhibiting trauma memory consolidation with transcranial theta burst stimulation to the dorsolateral prefrontal cortex

Background Following a traumatic event (e.g. witnessing or being victim of physical violence, death or serious injury), a significant minority of people will go on to suffer from acute stress disorder (ASD; in which symptoms occur for up to 1 month following the trauma) and/or PTSD (post-traumatic stress disorder). ASD and PTSD are characterised by involuntary, distressing (intrusive) memories (Brewin, 2011; Kindt, 2014). ‘Simple’ PTSD can be traced back to a single traumatic event and generates long lasting intrusive memories. Given the significant global burden of trauma exposure on both mental and physical health (Watson, 2019), it is crucial to develop effective therapies focussed on silencing intrusive memories. Recent research (Battaglia et al., 2024; Borgomaneri et al., 2020; Herrmann et al., 2025; Marin et al., 2018; Su et al., 2022) has demonstrated the use of transcranial magnetic stimulation (TMS) targeting the Dorsolateral Prefrontal Cortex (dlPFC) to disrupt fear memory (re/)consolidation. These studies have utilised inhibitory TMS protocols including low-frequency r-TMS and continuous theta-burst TMS (cTBS). For example, Battaglia et al. (2024) demonstrated low-frequency rTMS of the dlPFC immediately following fear conditioning interfered with recall at an immediate test, one hour later and 24 hours later. Thus far, studies have only demonstrated TMS reduced fear memory (re/)consolidation of simple CS-US Pavlovian fear conditioning (Battaglia et al., 2024; Borgomaneri et al., 2020; Su et al., 2022). With the exception of Hermann et al. (2025), who investigated if cTBS could be used to interfere with the reconsolidation of learned fear responses in spider phobia. Hermann et al. (2025) did not find a main effect of cTBS on spider phobia as measured by the spider phobia questionnaire. However, a correlation was found between the intensity of the cTBS and the reduction of symptom severity in the experimental group. As such, clinical translation requires further studies to determine whether TMS over the dlPFC can effectively interfere with more naturalistic trauma memory consolidation beyond simple Pavlovian fear conditioning. In the current study we propose using the ‘trauma-film’ paradigm which is well validated and widely used as an experimental model to study intrusive memories (James et al., 2016). The aim of the current study is to assess if this technique can be used to disrupt the consolidation of experimentally generated intrusive memories, acquired from more complex stimuli (distressing films), as a more realistic model of real trauma.