Evidence map›Paper›PMID 33832092›Full record

Trial reportMedicine2021

Repetitive transcranial magnetic stimulation in major depression: A three-arm parallel-group dose-response randomized pilot trial.

Kristoffer Johansson, Mats Adler, Ullvi Båve, Carl-Johan Ekman, Johan Lundberg

Abstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

5 authors.

Kristoffer JohanssonCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet.ORCID 0000-0001-9889-6519
Mats AdlerCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet.
Ullvi BåveCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet.
Carl-Johan EkmanCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet.
Johan LundbergCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet.

Funding

Stockholms Läns Landsting 20140210Vetenskapsrådet 523-2013-2982
6 · The paper itself

Abstract

backgroundThe optimal dose (number of pulses per session) of repetitive transcranial magnetic stimulation (rTMS), using the H-coil, in major depressive disorder (MDD) has not previously been reported.

objectiveTo explore the relationship between rTMS dose and antidepressant effect, and collect data for the design of a definitive trial.

methodsThis was a double-blind, three-arm parallel-group, randomized [1:1:1], pilot trial conducted in Stockholm, Sweden (September 2014 to September 2016). The primary outcome was change in depression severity measured with the Montgomery Åsberg Depression Rating Scale (MADRS) after 4 weeks. Participants (n = 29) with MDD were randomized to 1000, 2000, or 4000 pulses of rTMS for 20 sessions during 4 weeks.

resultsAt 4 weeks, the 3 treatment groups reduced the mean MADRS (95% CI) by 11.6 (4.0-19.2), 9.1 (5.0-13.3), and 11.3 (4.1-18.5) points respectively. Eleven participants met criteria for response and 10 for remission. No serious adverse events occurred. Ratings of subjective memory improved in all groups. Exploring the effect of dose and time, 4000 pulses had the largest reduction in MADRS during the first 2 weeks. A comparison of change in MADRS between 2000 and 4000 pulses after 2 weeks will require a sample size of 66 patients at power .80 and alpha .05.

conclusionsIt is feasible to conduct a definitive trial investigating whether a higher number of magnetic pulses per treatment session gives a more rapid antidepressive response.

Indexed as

AdultDouble-Blind MethodFemaleHumansMajor Depressive DisorderMaleMiddle AgedPilot ProjectsPsychiatric Status Rating ScalesTranscranial Magnetic Stimulation

Identifiers

PMID33832092
PMCPMC8036028

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Registered trials

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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.