Evidence map›Paper›PMID 31922372›Full record

Trial reportJournal of psychiatry & neuroscience : JPN2020

Magnetic seizure therapy is efficacious and well tolerated for treatment-resistant bipolar depression: an open-label clinical trial

Victor M. Tang, Daniel M. Blumberger, Julia Dimitrova, Alanah Throop, Shawn M. McClintock, Daphne Voineskos, Jonathan Downar, Yuliya Knyahnytska, Benoit H. Mulsant, Paul B. Fitzgerald and 1 more

Registry-linked trialOpen access · diamondAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of psychiatry & neuroscience : JPN, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01596608 (Efficacy and Tolerability of Magnetic Seizure Therapy), which is not on this map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
1.1field-weighted citation impact, top 25% 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.

NCT01596608 nacompletednot on this map

Efficacy and Tolerability of Magnetic Seizure Therapy (MST) as an Alternative to Electroconvulsive Therapy (ECT) for Treatment Resistant Depression, Schizophrenia, and Obsessive Compulsive Disorder

TypeinterventionalSponsorCentre for Addiction and Mental HealthRan2012 to 2019Enrolled224ConditionsDepressive Disorder, Schizophrenia, Schizoaffective Disorder, Obsessive-Compulsive DisorderArmsMagnetic Seizure Therapy (MagPro MST)
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 20 citations in OpenAlex.

  1. 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
  2. Pooled it
  3. Trial
  4. Trial
  5. Article
  6. Review
  7. Treatment-resistant bipolar depression: concepts and challenges for novel interventions.Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)
    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

11 authors at 7 institutions in 3 countries.

Victor M. TangFrom the Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ont., Canada (Tang, Blumberger, Dimitrova, Throop, Voineskos, Knyahnytska, Mulsant, Daskalakis); the Neurocognitive Research Laboratory, Department of Psychiatry, University of Texas Southwestern Medical Center, and Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC (McClintock); the Centre for Mental Health and Krembil Research Institute, University Health Network, Department of Psychiatry, University of Toronto, Toronto, Ont., Canada (Downar); and the Epworth Centre for Innovation in Mental Health, Epworth Healthcare and Monash Alfred Psychiatry Research Centre, the Alfred and Monash University Central Clinical School, Melbourne, Australia (Fitzgerald).
Daniel M. BlumbergerFrom the Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ont., Canada (Tang, Blumberger, Dimitrova, Throop, Voineskos, Knyahnytska, Mulsant, Daskalakis); the Neurocognitive Research Laboratory, Department of Psychiatry, University of Texas Southwestern Medical Center, and Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC (McClintock); the Centre for Mental Health and Krembil Research Institute, University Health Network, Department of Psychiatry, University of Toronto, Toronto, Ont., Canada (Downar); and the Epworth Centre for Innovation in Mental Health, Epworth Healthcare and Monash Alfred Psychiatry Research Centre, the Alfred and Monash University Central Clinical School, Melbourne, Australia (Fitzgerald).
Julia DimitrovaFrom the Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ont., Canada (Tang, Blumberger, Dimitrova, Throop, Voineskos, Knyahnytska, Mulsant, Daskalakis); the Neurocognitive Research Laboratory, Department of Psychiatry, University of Texas Southwestern Medical Center, and Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC (McClintock); the Centre for Mental Health and Krembil Research Institute, University Health Network, Department of Psychiatry, University of Toronto, Toronto, Ont., Canada (Downar); and the Epworth Centre for Innovation in Mental Health, Epworth Healthcare and Monash Alfred Psychiatry Research Centre, the Alfred and Monash University Central Clinical School, Melbourne, Australia (Fitzgerald).
Alanah ThroopFrom the Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ont., Canada (Tang, Blumberger, Dimitrova, Throop, Voineskos, Knyahnytska, Mulsant, Daskalakis); the Neurocognitive Research Laboratory, Department of Psychiatry, University of Texas Southwestern Medical Center, and Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC (McClintock); the Centre for Mental Health and Krembil Research Institute, University Health Network, Department of Psychiatry, University of Toronto, Toronto, Ont., Canada (Downar); and the Epworth Centre for Innovation in Mental Health, Epworth Healthcare and Monash Alfred Psychiatry Research Centre, the Alfred and Monash University Central Clinical School, Melbourne, Australia (Fitzgerald).
Shawn M. McClintockFrom the Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ont., Canada (Tang, Blumberger, Dimitrova, Throop, Voineskos, Knyahnytska, Mulsant, Daskalakis); the Neurocognitive Research Laboratory, Department of Psychiatry, University of Texas Southwestern Medical Center, and Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC (McClintock); the Centre for Mental Health and Krembil Research Institute, University Health Network, Department of Psychiatry, University of Toronto, Toronto, Ont., Canada (Downar); and the Epworth Centre for Innovation in Mental Health, Epworth Healthcare and Monash Alfred Psychiatry Research Centre, the Alfred and Monash University Central Clinical School, Melbourne, Australia (Fitzgerald).
Daphne VoineskosFrom the Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ont., Canada (Tang, Blumberger, Dimitrova, Throop, Voineskos, Knyahnytska, Mulsant, Daskalakis); the Neurocognitive Research Laboratory, Department of Psychiatry, University of Texas Southwestern Medical Center, and Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC (McClintock); the Centre for Mental Health and Krembil Research Institute, University Health Network, Department of Psychiatry, University of Toronto, Toronto, Ont., Canada (Downar); and the Epworth Centre for Innovation in Mental Health, Epworth Healthcare and Monash Alfred Psychiatry Research Centre, the Alfred and Monash University Central Clinical School, Melbourne, Australia (Fitzgerald).
Jonathan DownarFrom the Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ont., Canada (Tang, Blumberger, Dimitrova, Throop, Voineskos, Knyahnytska, Mulsant, Daskalakis); the Neurocognitive Research Laboratory, Department of Psychiatry, University of Texas Southwestern Medical Center, and Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC (McClintock); the Centre for Mental Health and Krembil Research Institute, University Health Network, Department of Psychiatry, University of Toronto, Toronto, Ont., Canada (Downar); and the Epworth Centre for Innovation in Mental Health, Epworth Healthcare and Monash Alfred Psychiatry Research Centre, the Alfred and Monash University Central Clinical School, Melbourne, Australia (Fitzgerald).
Yuliya KnyahnytskaFrom the Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ont., Canada (Tang, Blumberger, Dimitrova, Throop, Voineskos, Knyahnytska, Mulsant, Daskalakis); the Neurocognitive Research Laboratory, Department of Psychiatry, University of Texas Southwestern Medical Center, and Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC (McClintock); the Centre for Mental Health and Krembil Research Institute, University Health Network, Department of Psychiatry, University of Toronto, Toronto, Ont., Canada (Downar); and the Epworth Centre for Innovation in Mental Health, Epworth Healthcare and Monash Alfred Psychiatry Research Centre, the Alfred and Monash University Central Clinical School, Melbourne, Australia (Fitzgerald).
Benoit H. MulsantFrom the Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ont., Canada (Tang, Blumberger, Dimitrova, Throop, Voineskos, Knyahnytska, Mulsant, Daskalakis); the Neurocognitive Research Laboratory, Department of Psychiatry, University of Texas Southwestern Medical Center, and Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC (McClintock); the Centre for Mental Health and Krembil Research Institute, University Health Network, Department of Psychiatry, University of Toronto, Toronto, Ont., Canada (Downar); and the Epworth Centre for Innovation in Mental Health, Epworth Healthcare and Monash Alfred Psychiatry Research Centre, the Alfred and Monash University Central Clinical School, Melbourne, Australia (Fitzgerald).
Paul B. FitzgeraldFrom the Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ont., Canada (Tang, Blumberger, Dimitrova, Throop, Voineskos, Knyahnytska, Mulsant, Daskalakis); the Neurocognitive Research Laboratory, Department of Psychiatry, University of Texas Southwestern Medical Center, and Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC (McClintock); the Centre for Mental Health and Krembil Research Institute, University Health Network, Department of Psychiatry, University of Toronto, Toronto, Ont., Canada (Downar); and the Epworth Centre for Innovation in Mental Health, Epworth Healthcare and Monash Alfred Psychiatry Research Centre, the Alfred and Monash University Central Clinical School, Melbourne, Australia (Fitzgerald).
Zafiris J. DaskalakisFrom the Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ont., Canada (Tang, Blumberger, Dimitrova, Throop, Voineskos, Knyahnytska, Mulsant, Daskalakis); the Neurocognitive Research Laboratory, Department of Psychiatry, University of Texas Southwestern Medical Center, and Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC (McClintock); the Centre for Mental Health and Krembil Research Institute, University Health Network, Department of Psychiatry, University of Toronto, Toronto, Ont., Canada (Downar); and the Epworth Centre for Innovation in Mental Health, Epworth Healthcare and Monash Alfred Psychiatry Research Centre, the Alfred and Monash University Central Clinical School, Melbourne, Australia (Fitzgerald).
Duke University · USKrembil Research InstituteUniversity of Toronto · CACentre for Addiction and Mental Health · CAMonash Alfred Psychiatry Research centre · AUMonash University · AUThe University of Texas Southwestern Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Treatment-resistant bipolar depression can be treated effectively using electroconvulsive therapy, but its use is limited because of stigma and cognitive adverse effects. Magnetic seizure therapy is a new convulsive therapy with promising early evidence of antidepressant effects and minimal cognitive adverse effects. However, there are no clinical trials of the efficacy and safety of magnetic seizure therapy for treatment-resistant bipolar depression. Methods: Participants with treatment-resistant bipolar depression were treated with magnetic seizure therapy for up to 24 sessions or until remission. Magnetic seizure therapy was applied over the prefrontal cortex at high (100 Hz; n = 8), medium (50 or 60 Hz; n = 9) or low (25 Hz; n = 3) frequency, or over the vertex at high frequency (n = 6). The primary outcome measure was the 24-item Hamilton Rating Scale for Depression. Participants completed a comprehensive battery of neurocognitive tests. Results: Twenty-six participants completed a minimally adequate trial of magnetic seizure therapy (i.e., ≥ 8 sessions), and 20 completed full treatment per protocol. Participants showed a significant reduction in scores on the Hamilton Rating Scale for Depression. Adequate trial completers had a remission rate of 23.1% and a response rate of 38.5%. Per-protocol completers had a remission rate of 30% and a response rate of 50%. Almost all cognitive measures remained stable, except for significantly worsened recall consistency on the autobiographical memory inventory. Limitations: The open-label study design and modest sample size did not allow for comparisons between stimulation parameters. Conclusion: In treatment-resistant bipolar depression, magnetic seizure therapy produced significant improvements in depression symptoms with minimal effects on cognitive performance. These promising results warrant further investigation with larger randomized clinical trials comparing magnetic seizure therapy to electroconvulsive therapy. Clinical trial registration: NCT01596608; clinicaltrials.gov

Indexed as

Convulsive TherapyMagnetic Field TherapyOutcome Assessment, Health CareAdultBipolar DisorderDepressive Disorder, Treatment-ResistantFemaleHumansMaleMiddle AgedPrefrontal CortexSkull

Identifiers

PMID31922372
PMCPMC7850154
OpenAlexW3011426227

What OpenQuestion holds

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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.