Evidence map›Paper›PMID 29085773›Full record

Trial reportNeuroImage. Clinical2017

Neurobiological and clinical effects of fNIRS-controlled rTMS in patients with panic disorder/agoraphobia during cognitive-behavioural therapy.

Saskia Deppermann, Nadja Vennewald, Julia Diemer, Stephanie Sickinger, Florian B Haeussinger, Thomas Dresler, Swantje Notzon, Inga Laeger, Volker Arolt, Ann-Christine Ehlis and 2 more

Open access · goldAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in NeuroImage. Clinical, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 5 pooled it
1.6field-weighted citation impact, top 16% 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

19 citing papers in PubMed, 5 syntheses or guidelines pooled it, 38 citations in OpenAlex.

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  9. Neuromodulation of Fear and Anxiety Circuits.Current topics in behavioral neurosciences · 2025
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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

12 authors at 2 institutions in 1 country.

Saskia DeppermannDepartment of Psychiatry and Psychotherapy, Calwerstr. 14, University of Tuebingen, 72076 Tuebingen, Germany.
Nadja VennewaldMood and Anxiety Disorders Research Unit, Department of Psychiatry and Psychotherapy, Albert-Schweitzer-Campus 1, University of Muenster, Muenster, Germany.
Julia DiemerMood and Anxiety Disorders Research Unit, Department of Psychiatry and Psychotherapy, Albert-Schweitzer-Campus 1, University of Muenster, Muenster, Germany.
Stephanie SickingerDepartment of Psychiatry and Psychotherapy, Calwerstr. 14, University of Tuebingen, 72076 Tuebingen, Germany.
Florian B HaeussingerDepartment of Psychiatry and Psychotherapy, Calwerstr. 14, University of Tuebingen, 72076 Tuebingen, Germany.
Thomas DreslerDepartment of Psychiatry and Psychotherapy, Calwerstr. 14, University of Tuebingen, 72076 Tuebingen, Germany.
Swantje NotzonMood and Anxiety Disorders Research Unit, Department of Psychiatry and Psychotherapy, Albert-Schweitzer-Campus 1, University of Muenster, Muenster, Germany.
Inga LaegerMood and Anxiety Disorders Research Unit, Department of Psychiatry and Psychotherapy, Albert-Schweitzer-Campus 1, University of Muenster, Muenster, Germany.
Volker AroltMood and Anxiety Disorders Research Unit, Department of Psychiatry and Psychotherapy, Albert-Schweitzer-Campus 1, University of Muenster, Muenster, Germany.
Ann-Christine EhlisDepartment of Psychiatry and Psychotherapy, Calwerstr. 14, University of Tuebingen, 72076 Tuebingen, Germany.
Andreas J FallgatterDepartment of Psychiatry and Psychotherapy, Calwerstr. 14, University of Tuebingen, 72076 Tuebingen, Germany.
Peter ZwanzgerMood and Anxiety Disorders Research Unit, Department of Psychiatry and Psychotherapy, Albert-Schweitzer-Campus 1, University of Muenster, Muenster, Germany.
University of Tübingen · DEInn-Salzach-Klinikum · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA relevant proportion of patients with panic disorder (PD) does not improve even though they receive state of the art treatment for anxiety disorders such as cognitive-behavioural therapy (CBT). At the same time, it is known, that from a neurobiological point of view, PD patients are often characterised by prefrontal hypoactivation. Intermittent Theta Burst Stimulation (iTBS) is a non-invasive type of neurostimulation which can modulate cortical activity and thus has the potential to normalise prefrontal hypoactivity found in PD. We therefore aimed at investigating the effects of iTBS as an innovative add-on to CBT in the treatment for PD.

methodsIn this double-blind, bicentric study, 44 PD patients, randomised to sham or verum stimulation, received 15 sessions of iTBS over the left prefrontal cortex (PFC) in addition to 9 weeks of group CBT. Cortical activity during a cognitive as well as an emotional (Emotional Stroop) paradigm was assessed both at baseline and post-iTBS treatment using functional near-infrared spectroscopy (fNIRS) and compared to healthy controls.

resultsIn this manuscript we only report the results of the emotional paradigm; for the results of the cognitive paradigm please refer to Deppermann et al. (2014). During the Emotional Stroop test, PD patients showed significantly reduced activation to panic-related compared to neutral stimuli for the left PFC at baseline. Bilateral prefrontal activation for panic-related stimuli significantly increased after verum iTBS only. Clinical ratings significantly improved during CBT and remained stable at follow-up. However, no clinical differences between the verum- and sham-stimulated group were identified, except for a more stable reduction of agoraphobic avoidance during follow-up in the verum iTBS group. LIMITATIONS: Limitations include insufficient blinding, the missing control for possible state-dependent iTBS effects, and the timing of iTBS application during CBT.

conclusionPrefrontal hypoactivity in PD patients was normalised by add-on iTBS. Clinical improvement of anxiety symptoms was not affected by iTBS.

Indexed as

Cognitive Behavioral TherapyTranscranial Magnetic StimulationAdultAgoraphobiaDouble-Blind MethodEmotionsFemaleHumansMaleMiddle AgedPanic DisorderPrefrontal CortexSpectroscopy, Near-InfraredStroop TestTreatment OutcomeYoung AdultANOVA, analysis of varianceCAQ, Cardiac Anxiety QuestionnaireCBSI, correlation-based signal improvementCBT, cognitive-behavioural therapyCognitive-behavioural therapyEmotion regulationER, error ratefNIRS, functional near-infrared spectroscopyFunctional near-infrared spectroscopyHAM-A, Hamilton Anxiety Rating ScaleHHb, deoxyhemoglobinIntermittent Theta Burst StimulationiTBS, intermittent Theta Burst StimulationLOCF, last observation carried forwardO2Hb, oxyhemoglobinPanic disorderPAS, Panic and Agoraphobia ScalePD, panic disorderPFC, prefrontal cortexRM-ANOVA, repeated-measures analysis of varianceROI, region of interestrTMS, repetitive Transcranial Magnetic StimulationRT, reaction time

Identifiers

PMID29085773
PMCPMC5650598
OpenAlexW2756841235

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.