Evidence map›Paper›PMID 29946106›Full record

Trial reportNeuropsychopharmacology : official publication of the American College of Neuropsychopharmacology2018

Efficacy, tolerability, and cognitive effects of deep transcranial magnetic stimulation for late-life depression: a prospective randomized controlled trial.

Tyler S Kaster, Zafiris J Daskalakis, Yoshihiro Noda, Yuliya Knyahnytska, Jonathan Downar, Tarek K Rajji, Yechiel Levkovitz, Abraham Zangen, Meryl A Butters, Benoit H Mulsant and 1 more

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 82 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
82citing papers in PubMed, 11 pooled it
6.1field-weighted citation impact, top 3% 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

82 citing papers in PubMed, 11 syntheses or guidelines pooled it, 160 citations in OpenAlex.

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  14. Clinical effects and correlates of standard rTMS and theta burst stimulation (TBS) on suicidal ideation in late-life depression.European psychiatry : the journal of the Association of European Psychiatrists · 2025
    Trial
  15. Depression and anxiety in vascular dementia: an update.Journal of neural transmission (Vienna, Austria : 1996) · 2026
    Review
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  18. Effects of repetitive transcranial magnetic stimulation on motor ability, neurophysiological changes, mental health, and activities of daily living in spinal cord injury: a systematic review and meta-analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
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22 more citing papers are in PubMed but not listed here.

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

11 authors at 6 institutions in 4 countries.

Tyler S KasterTemerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada.
Zafiris J DaskalakisTemerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada.
Yoshihiro NodaDepartment of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.
Yuliya KnyahnytskaTemerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada.
Jonathan DownarDepartment of Psychiatry, University of Toronto, Toronto, ON, Canada.ORCID http://orcid.org/0000-0002-5140-174X
Tarek K RajjiDepartment of Psychiatry, University of Toronto, Toronto, ON, Canada.
Yechiel LevkovitzBe'er-Ya'akov Mental Health Center, Tel Aviv University, Be'er-Ya'akov, Israel.
Abraham ZangenDepartment of Life Sciences and the Zlotowsky Neuroscience Center, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
Meryl A ButtersDepartment of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Benoit H MulsantDepartment of Psychiatry, University of Toronto, Toronto, ON, Canada.
Daniel M BlumbergerTemerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada. daniel.blumberger@camh.ca.
Centre for Addiction and Mental Health · CABen-Gurion University of the Negev · ILKeio University · JPTel Aviv University · ILUniversity of Pittsburgh · USUniversity of Toronto · CA

Funding

Gouvernement du Canada | Canadian Institutes of Health Research (Instituts de Recherche en Santé du Canada) ISO-115293
6 · The paper itself

Abstract

Late-life depression (LLD) is a growing worldwide problem due to demographic changes, with limited treatment options due to high rates of pharmacotherapy adverse effects, accessibility of psychotherapy, and tolerability of electroconvulsive therapy. Novel neuromodulation techniques, such as repetitive transcranial magnetic stimulation (rTMS), may overcome these limitations. The objective of this study is to determine the efficacy, tolerability, and cognitive effects of high-dose deep rTMS in LLD. In this study we randomized older adults between 60 and 85 years old with major depressive disorder (MDD) to sham or active deep rTMS (H1 coil, 6012 pulses, 18 Hz, 120% of resting motor threshold) delivered over the dorsolateral and ventrolateral prefrontal cortex 5 days per week over 4 weeks. Our primary outcome was remission of depression in an intention-to-treat analysis. We also assessed change in cognitive functioning with rTMS treatment and tolerability based on adverse effects. Fifty-two participants were randomized to active (n = 25) or sham H1 coil (n = 27). Remission rate was significantly higher with active than sham rTMS (40.0% vs 14.8%) with a number needed to treat of 4.0 (95% CI: 2.1-56.5). There was no change on any measure of executive function and no serious adverse events. Adverse effect profiles were similar between active and sham rTMS, except for reports of pain being significantly more common in the active condition (16.0% vs 0%). High-dose deep rTMS appears to be safe, well tolerated, and efficacious in the treatment of LLD.

Indexed as

AgedAged, 80 and overAge FactorsCognitionDepressive Disorder, Treatment-ResistantDouble-Blind MethodExecutive FunctionFemaleHumansMaleMiddle AgedProspective StudiesTranscranial Direct Current StimulationTranscranial Magnetic StimulationTreatment Outcome

Identifiers

PMID29946106
PMCPMC6135812
OpenAlexW2808186671

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.