Evidence map›Paper›PMID 30012789›Full record

Trial reportBMJ open2018

Randomised controlled feasibility trial of real versus sham repetitive transcranial magnetic stimulation treatment in adults with severe and enduring anorexia nervosa: the TIARA study.

Bethan Dalton, Savani Bartholdy, Jessica McClelland, Maria Kekic, Samantha J Rennalls, Jessica Werthmann, Ben Carter, Owen G O'Daly, Iain C Campbell, Anthony S David and 3 more

Registry-linked trialOpen access · goldAbstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05788042 (Randomised Controlled Trial of Neurostimulation for Symptoms of Anorexia Nervosa), which is not on this map. Cited by 47 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
47citing papers in PubMed, 4 pooled it
4.3field-weighted citation impact, top 5% 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.

NCT05788042 narecruitingnot on this mapstarted 2023, after this paper: background citation

Randomised Controlled Trial of Neurostimulation for Symptoms of Anorexia Nervosa

TypeinterventionalSponsorThe George InstituteRan2023 to 2026Enrolled70ConditionsAnorexia NervosaArmsMagPro TMS device (ARTG: 204659), tDCS mini-CT Stimulator (Soterix, USA: ARTG: 284637)
3 · Its place in the literature

Who cites it

47 citing papers in PubMed, 4 syntheses or guidelines pooled it, 81 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Trial
  6. Trial
  7. Trial
  8. Trial
  9. Trial
  10. Clinical staging for eating disorders: A scoping review and update.European psychiatry : the journal of the Association of European Psychiatrists · 2026
    Article
  11. Review
  12. Article
  13. rTMS Therapy for Eating Disorders: Scoping Review on Efficacy, Safety, Stimulation Parameters and Study Subjects.European eating disorders review : the journal of the Eating Disorders Association · 2026
    Review
  14. Recent developments in treatments for eating disorders.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2026
    Review
  15. Article
  16. Article
  17. Review
  18. Review
  19. Anorexia Nervosa Across the Lifespan: A Review of Recent Literature.Focus (American Psychiatric Publishing) · 2024
    Review
  20. Article
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

13 authors at 3 institutions in 1 country.

Bethan Dalton *Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.ORCID 0000-0003-0898-1926
Savani Bartholdy *Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Jessica McClelland *Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Maria KekicSection of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Samantha J RennallsDepartment of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Jessica WerthmannSection of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Ben CarterDepartment of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Owen G O'DalyDepartment of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Iain C CampbellSection of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Anthony S DavidDepartment of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Danielle GlennonEating Disorders Service, South London and Maudsley NHS Foundation Trust, London, UK.
Nikola KernEating Disorders Service, South London and Maudsley NHS Foundation Trust, London, UK.
Ulrike SchmidtSection of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
King's College London · GBSouth London and Maudsley NHS Foundation Trust · GBWellcome Centre for Human Neuroimaging · GB

Funding

Department of Health PB-PG-1013-32049Wellcome Trust
6 · The paper itself

Abstract

objectiveTreatment options for severe, enduring anorexia nervosa (SE-AN) are limited. Non-invasive neuromodulation is a promising emerging intervention. Our study is a feasibility randomised controlled trial of repetitive transcranial magnetic stimulation (rTMS) in individuals with SE-AN, which aims to inform the design of a future large-scale trial.

designDouble-blind, parallel group, two-arm, sham-controlled trial.

settingSpecialist eating disorders centre.

participantsCommunity-dwelling people with anorexia nervosa, an illness duration of ≥3 years and at least one previous completed treatment.

interventionsParticipants received 20 sessions (administered over 4 weeks) of MRI-guided real or sham high-frequency rTMS to the left dorsolateral prefrontal cortex in addition to treatment-as-usual. OUTCOMES: Primary outcomes were recruitment, attendance and retention rates. Secondary outcomes included body mass index (BMI), eating disorder symptoms, mood, quality of life and rTMS safety and tolerability. Assessments were conducted at baseline, post-treatment and follow-up (ie, at 0 month, 1 month and 4 months post-randomisation).

resultsThirty-four participants (17 per group) were randomly allocated to real or sham rTMS. One participant per group was withdrawn prior to the intervention due to safety concerns. Two participants (both receiving sham) did not complete the treatment. rTMS was safe and well tolerated. Between-group effect sizes of change scores (baseline to follow-up) were small for BMI (

conclusionsThe treatment protocol is feasible and acceptable to participants. Outcomes provide preliminary evidence for the therapeutic potential of rTMS in SE-AN. Largest effects were observed on variables assessing mood. This study supports the need for a larger confirmatory trial to evaluate the effectiveness of multi-session rTMS in SE-AN. Future studies should include a longer follow-up period and an assessment of cost-effectiveness. TRIAL REGISTRATION NUMBER: ISRCTN14329415; Pre-results.

Indexed as

Transcranial Magnetic StimulationAdultAnorexia NervosaClinical ProtocolsDouble-Blind MethodFeasibility StudiesFemaleHumansPrefrontal CortexSeverity of Illness IndexTreatment Outcomeanorexia nervosaeating disordersneuromodulationrepetitive transcranial magnetic stimulation (rTMS)

Identifiers

PMID30012789
PMCPMC6082449
OpenAlexW2883391875

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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.