Researching the future of brain-based mental health care

• Randomized, double-blind, sham-controlled pilot study evaluating personalized, EEG-guided rTMS (MeRT) in 73 military veterans with PTSD (36 active, 37 sham) over 10 treatment sessions in two weeks.
• Significant reduction in PTSD symptom severity: Active treatment achieved a 33.9% reduction in PCL-M scores (22.4-point mean improvement), compared to 24.0% (15.9 points) with sham (p=0.049).
• 78% achieved clinically meaningful PTSD improvement: 28 of 36 active-treatment participants experienced a ≥10-point PCL-M reduction, compared to 49% (18 of 37) receiving sham (p=0.01).
• Significant improvement in sleep quality: Active treatment reduced PSQI-A scores by 43.9%, compared to 16.4% with sham (p=0.030). Depression symptom improvements did not significantly differ between groups (p=0.130).
• No severe adverse events reported: Side effects were mild, most commonly headaches, which resolved within one week without medical intervention.

‍

• First FDA-cleared personalized, EEG-guided TMS treatment: cleared June 3, 2026 as an adjunct treatment for PTSD in adults (FDA Breakthrough Device Designation, November 2024).
• Multi-site, prospective, double-blind, randomized, sham-controlled pivotal trial; intention-to-treat n=158 (77 active, 81 sham), 20–25 sessions, 84% completion.
• Primary endpoint met: significant PCL-5 improvement vs sham (p<0.046); clinician-administered CAPS-5 separation stronger (p<0.0006) — the first randomized controlled trial in which personalized TMS separated from sham for PTSD.
• Active-arm PCL-5 improvement of 27 points, roughly two to three times the established 8.5–12.5-point minimal clinically important difference; 68.2% of the active group met remission criteria at follow-up F2.
• Zero serious adverse events; improvement durable through the 2–4 month follow-up window.

• Randomized controlled trial: 20 children (ages 6–12) with level-2 autism assigned 1:1 to immediate alpha rhythm-guided rTMS (ten sessions over two weeks) or waitlist control, with crossover.
• Treatment group improved significantly more than controls on total Children's Sleep Habits Questionnaire score (p=.008) and on bedtime resistance (p=.003), sleep-onset delay (p=.004), and sleep duration (p=.003).
• Objective confirmation at crossover: polysomnography showed reduced wake-after-sleep-onset (p=.014), improved sleep efficiency (p=.046), and improved N2 stage (p=.039).
• Improvements persisted to the four-month follow-up (actigraphy wake-after-sleep-onset significant at one and four months); side effects were mild and transient.
• First randomized controlled trial of the alpha-guided (MeRT) protocol for sleep difficulties in pediatric autism (ANZCTR: ACTRN12623000757617).

• Exploratory EEG companion to the randomized sleep trial (20 children with ASD, ages 6–12): does alpha-guided rTMS engage its purported target, the individual alpha rhythm itself?
• Treated children showed a significant increase in mean frontal individual alpha frequency (9.09 Hz to 9.35 Hz; p=0.021) compared with waitlist controls.
• Decreased posterior-frontal differences suggested enhanced long-range functional connectivity, persisting through the four-month follow-up.
• Direct target-engagement evidence for the personalization thesis: stimulation calibrated to a patient's alpha rhythm measurably shifts that rhythm. Co-authored with Wave Neuroscience.

• Retrospective chart review of 33 male Special Operations Forces veterans with comorbid PTSD and TBI symptoms; alpha-guided rTMS delivered five days per week at each veteran's individual alpha frequency.
• TBI symptom severity decreased an average of 54% on the Rivermead Post-Concussion Questionnaire (p<0.01); PTSD severity decreased an average of 37.6% on the PCL-5 (p<0.01).
• Of participants above the PCL-5 screening threshold of 33, 69% no longer met clinical criteria for PTSD at the end of the program.
• Side effects were consistent with standard TMS (most frequently headache and fatigue) — no new safety signal in a comorbid PTSD+TBI population.

• Retrospective chart review of 28 autistic children (ages 3–9; mean 6.1 years) who received 19 sessions of individual-alpha-frequency-guided rTMS over four weeks.
• Individual alpha frequency shifted significantly toward the mature 10 Hz norm (to 9.4 Hz; p≤0.025) — biomarker movement alongside clinical change.
• Autism symptoms (Childhood Autism Rating Scale) and quality of life (PedsQL 4.0) improved significantly; semi-structured interviews most often highlighted improved sleep.
• Minor side effects (e.g., transient hyperactivity) resolved within about two hours of sessions.

• Retrospective chart review of an Air Force Special Operations Command Human Performance Optimization program delivering an average of 30 sessions of individualized alpha-frequency rTMS to active-duty operators following traumatic brain injury.
• PCL-5 (PTSD) scores fell an average of 37% (p<.01) — from 42.9 to 27, below the clinical threshold of 33 for presence of PTSD.
• PROMIS depression T-scores fell 11.3% and perceived cognitive deficits (PDQ) fell 45.5% by session 30 (both p<.01); 46% of members above depression thresholds at baseline resolved after treatment.
• Side effects matched those commonly reported for rTMS — preliminary support for safe use in an active-duty military setting.

• First peer-reviewed clinical report of the alpha-guided protocol that became MeRT: open-label evaluation of 21 consecutively treated veterans with PTSD (16 completed two weeks of treatment).
• PCL-M scores improved from an average of 54.9 to 31.8 (p<0.001).
• EEG normalized alongside symptoms: relative global alpha power rose from 32.0% to 38.5% (p=0.013) and delta power fell from 32.3% to 26.8% (p=0.028).
• Treatment frequency was derived from frequency-domain analysis of each patient's alpha-band EEG and resting heart rate — the EEG+ECG personalization approach later engineered into the MeRT system.