Evidence map›Paper›PMID 27447245›Full record

ArticleJournal of child and adolescent psychopharmacology2016

Seizure Induced by Deep Transcranial Magnetic Stimulation in an Adolescent with Depression.

Kathryn R Cullen, Suzanne Jasberg, Brent Nelson, Bonnie Klimes-Dougan, Kelvin O Lim, Paul E Croarkin

Open access · greenAbstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of child and adolescent psychopharmacology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 3 pooled it
2.9field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 3 syntheses or guidelines pooled it, 31 citations in OpenAlex.

  1. Pooled it
  2. Safety and recommendations for TMS use in healthy subjects and patient populations, with updates on training, ethical and regulatory issues: Expert Guidelines.Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2021
    Guideline
  3. Pooled it
  4. Efficacy, tolerability, and cognitive effects of deep transcranial magnetic stimulation for late-life depression: a prospective randomized controlled trial.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2018
    Trial
  5. Review
  6. Article
  7. The use of noninvasive brain stimulation techniques in autism spectrum disorder.Autism research : official journal of the International Society for Autism Research · 2024
    Article
  8. Review
  9. Review
  10. Review
  11. New Somatic Treatments for Child and Adolescent Depression.Current treatment options in psychiatry · 2019
    Article
  12. Seizures from transcranial magnetic stimulation 2012-2016: Results of a survey of active laboratories and clinics.Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2019
    Article
  13. Transcranial Magnetic Stimulation for Adolescent Depression.Child and adolescent psychiatric clinics of North America · 2019
    Review
  14. Review
  15. Pediatric Neuromodulation Comes of Age.Journal of child and adolescent psychopharmacology · 2016
    Article
  16. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Kathryn R Cullen1 Department of Psychiatry, University of Minnesota , Minneapolis, Minnesota.
Suzanne Jasberg1 Department of Psychiatry, University of Minnesota , Minneapolis, Minnesota.
Brent Nelson1 Department of Psychiatry, University of Minnesota , Minneapolis, Minnesota.
Bonnie Klimes-Dougan1 Department of Psychiatry, University of Minnesota , Minneapolis, Minnesota.
Kelvin O Lim1 Department of Psychiatry, University of Minnesota , Minneapolis, Minnesota.
Paul E Croarkin2 Department of Psychiatry and Psychology, Mayo Clinic , Rochester, Minnesota.
University of Minnesota · USMayo Clinic · US

Funding

Glutamate Probes in Adolescent DepressionK23MH100266 · NIMH · MAYO CLINIC ROCHESTER · PI CROARKIN, PAUL E · 2014 to 2017
$685k
NIMH NIH HHS K23 MH100266
6 · The paper itself

Abstract

objectiveDeep transcranial magnetic stimulation (TMS) with an H-1 coil was recently approved by the U.S. Food and Drug Administration (U.S. FDA) for treatment-resistant depression (TRD) in adults. Studies assessing the safety and effectiveness of deep TMS in adolescent TRD are lacking. The purpose of this brief report is to provide a case history of an adolescent enrolled in an investigational deep TMS protocol.

methodsA case history is described of the first participant of a sham-controlled clinical trial who had a seizure in the course of deep TMS with parameter settings extrapolated from the adult studies that led to US FDA approval (H-1 coil, 120% target stimulation intensity, 18 Hz, 55 trains of 2-second duration, total 1980 pulses).

resultsThe participant was a 17-year-old unmedicated female, with no significant medical history and no history of seizures or of drug or alcohol use. Brain magnetic resonance imaging showed no structural abnormalities. She initially received sham, which was well tolerated. During active treatment sessions, titration began at 85% of motor threshold (MT) and increased by 5% per day. Her weekly MT measurements were stable. On her first day of 120% MT (8th active treatment), during the 48th train, the participant had a generalized, tonic-clonic seizure that lasted 90 seconds and resolved spontaneously. She had an emergency medicine evaluation and was discharged home without anticonvulsant medications. There were no further seizures reported at a 6-month follow-up.

conclusionsWe report a deep TMS-induced generalized tonic-clonic seizure in an adolescent with TRD participating in a clinical trial. Given the demonstrated benefits of deep TMS for adult TRD, research investigating its use in adolescents with TRD is an important area. However, in light of this experience, additional precautions for adolescents should be considered. We propose that further dose-finding investigations are needed to refine adolescent-specific parameters that may be safe and effective for treating adolescents with TRD with deep TMS.

Indexed as

AdolescentBrainDepressive Disorder, Treatment-ResistantFemaleFollow-Up StudiesHumansMagnetic Resonance ImagingSeizuresTranscranial Magnetic Stimulation

Identifiers

PMID27447245
PMCPMC5118961
OpenAlexW2485155568

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.