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Letter to the Editor   |    
Drs. Hoffman and Cavus Reply
RALPH E. HOFFMAN, M.D.; IDIL CAVUS, M.D., Ph.D.
Am J Psychiatry 2004;161:928-a-929. doi:10.1176/appi.ajp.161.5.928-a
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To the Editor: We regret that when discussing the TMS effects reported by d’Alfonso et al. (2000) as they might pertain to an rTMS case series of PTSD patients, we misrepresented the effects of right prefrontal stimulation on attention when normal subjects responded to angry faces (p. 1096). Later data reported by van Honk et al. (2002) showing reduced attentional response to fearful faces after right-sided prefrontal slow rTMS are of considerable interest. As noted, the study by d’Alfonso et al. showed the opposite rTMS effect when faces were angry. The findings of the two studies, when considered together, provide new insights into differing—but perhaps complementary—prefrontal neurocircuitry underlying responses to faces expressing these two negative emotions. Such findings suggest that slow prefrontal rTMS could provide a fruitful method for probing altered emotion neurocircuitry in patients with PTSD.

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