High-pressure work, being continuously connected though our phones and demanding schedules make recovery from stress increasingly more difficult. What does TMS research tell us about the brain’s ability to regulate and recover?
Stress has become an almost unavoidable part of modern life. This can leave little time for the brain and body to fully switch off. Experiencing stress from time to time is normal. But when stressful periods become frequent, the ability to regulate and recover from them becomes increasingly important.
This is where TMS research is beginning to tell an interesting story. Rather than simply asking whether stress can be avoided, researchers are investigating whether TMS can influence brain networks involved in regulating and recovering from stress.
The brain has its own stress-regulation system
One region receiving particular attention in research is the dorsolateral prefrontal cortex (DLPFC). This region contributes to cognitive control and interacts with wider networks involved in emotional processing and regulation. Using TMS, researchers can non-invasively stimulate this area and investigate whether changing its activity also changes the way people respond to stressful experiences. [1,2]
Kim et al. studied 24 healthcare professionals experiencing occupational stress. Participants received 12 sessions of active or sham high-frequency rTMS over the left DLPFC. Active stimulation was associated with improvements in occupational-stress-related measures and depressive symptoms. The study was small, but it provided early controlled evidence in a non-patient occupational-stress population. [1]
More recently, He et al. studied young adults reporting high levels of perceived stress. After 12 sessions of DLPFC rTMS, active stimulation was associated with greater improvement in perceived-stress outcomes than sham. Functional imaging also identified changes in network topology, suggesting that changes in perceived stress occurred alongside measurable changes in brain-network organization. [2]
Recovery may matter as much as stress response
Stress is not only something we feel. Acute stress also produces a physiological response involving hormones such as cortisol. Wang et al. used the Trier Social Stress Test and then applied high-frequency rTMS over the left DLPFC. Cortisol concentrations were lower during the post-stress recovery period in the stimulation group than in the stress-only group, supporting the authors’ interpretation that left-DLPFC activation may accelerate recovery after an acute laboratory stressor. [3]
A systematic review by Vignaud et al. similarly concluded that prefrontal non-invasive brain stimulation can modulate stress-induced cortisol responses, with high-frequency left-DLPFC rTMS among the promising approaches. The authors also emphasized heterogeneity and the need for larger, standardized studies. [4]
The emerging picture is therefore less about eliminating stress and more about regulation and recovery. Current studies suggest that prefrontal rTMS can influence selected psychological and physiological measures of stress under research conditions. The evidence remains preliminary and protocol-specific, and it does not establish TMS as a general treatment for everyday stress in healthy populations. Still, it opens an intriguing research question: can stimulation of prefrontal networks support the brain’s ability to reset and recover after stress? [1-4]
References
[1] Kim YI, Kim SM, Kim H, Han DH. The Effect of High-Frequency Repetitive Transcranial Magnetic Stimulation on Occupational Stress among Health Care Workers: A Pilot Study. Psychiatry Investig. 2016;13(6):622-629. doi:10.4306/pi.2016.13.6.622.
[2] He Y, Li Z, Cao L, et al. Effects of dorsolateral prefrontal cortex stimulation on network topological attributes in young individuals with high-level perceived stress: A randomized controlled trial. Psychiatry Res. 2023;326:115297. doi:10.1016/j.psychres.2023.115297.
[3] Wang Y, Gao H, Qi M. Left dorsolateral prefrontal cortex activation can accelerate stress recovery: A repetitive transcranial stimulation study. Psychophysiology. 2023;60(10):e14352. doi:10.1111/psyp.14352.
[4] Vignaud P, Adam O, Palm U, et al. Can a single session of noninvasive brain stimulation applied over the prefrontal cortex prevent stress-induced cortisol release? Prog Neuropsychopharmacol Biol Psychiatry. 2023;121:110667. doi:10.1016/j.pnpbp.2022.110667.
