Evidence map›Paper›PMID 33866020›Full record

Trial reportBrain stimulation

Targeting location relates to treatment response in active but not sham rTMS stimulation.

A C Rosen, J V Bhat, V A Cardenas, T J Ehrlich, A M Horwege, D H Mathalon, B J Roach, G H Glover, B W Badran, S D Forman and 9 more

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

Trial report in Brain stimulation. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 2 pooled it
3.7field-weighted citation impact, top 6% 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

27 citing papers in PubMed, 2 syntheses or guidelines pooled it, 53 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
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  7. Review
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  14. A New Angle on Transcranial Magnetic Stimulation Coil Orientation: A Targeted Narrative Review.Biological psychiatry. Cognitive neuroscience and neuroimaging · 2024
    Review
  15. Review
  16. The Brain Connectome for Clinical Neuroscience.Advances in experimental medicine and biology · 2024
    Review
  17. Article
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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

19 authors at 12 institutions in 2 countries.

A C RosenVeterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Department of Psychiatry, Stanford University, Stanford, CA, 94305, USA. Electronic address: rosena@stanford.edu.
J V BhatVeterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Palo Alto Veterans Institute for Research, Palo Alto, CA, 94304, USA.
V A CardenasVeterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.
T J EhrlichVeterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; University of Michigan, Ann Arbor, USA.
A M HorwegeVeterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.
D H MathalonMental Health Service, San Francisco Veterans Affairs Health Care System, University of California, San Francisco, CA, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA.
B J RoachMental Health Service, San Francisco Veterans Affairs Health Care System, University of California, San Francisco, CA, USA; Northern California Institute for Research and Education, San Francisco Veterans Affairs Medical Center, University of California, San Francisco, CA, USA.
G H GloverDepartment of Radiology, Stanford University, Stanford, CA, USA.
B W BadranBrain Stimulation Division, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA.
S D FormanDepartment of Veterans Affairs, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA; Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
M S GeorgeBrain Stimulation Division, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson VA Medical Center, Charleston, SC, USA.
M E ThaseVISN4 Mental Illness Research, Education, and Clinical Center at the Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, 19104, USA; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
D Yurgelun-ToddRocky Mountain Network Mental Illness Research Education and Clinical Centers (VISN 19), VA Salt Lake City Health Care System, Salt Lake City, UT, USA; Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA.
M E SughrueOmniscient Neurotechnologies, Sydney, Australia; Prince of Wales Hospital, Randwick, NSW, Australia.
S P DoyenOmniscient Neurotechnologies, Sydney, Australia.
P J NicholasOmniscient Neurotechnologies, Sydney, Australia.
J C ScottVISN4 Mental Illness Research, Education, and Clinical Center at the Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, 19104, USA; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
L TianDepartment of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA.
J A YesavageVeterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Department of Psychiatry, Stanford University, Stanford, CA, 94305, USA.
VA Palo Alto Health Care System · USMedical University of South Carolina · USStanford University · USPalo Alto Veterans Institute for Research · USPhiladelphia VA Medical Center · USPrince of Wales Hospital · AUSan Francisco VA Medical Center · USUniversity of California, San Francisco · USUniversity of Michigan–Ann Arbor · USUniversity of Pittsburgh · USUniversity of Utah · USVA Healthcare-VISN 4 · US

Funding

Treating Depression and Enhancing Locomotor Recovery Post-strokeP20GM109040 · NIGMS · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI KAUTZ, STEVEN A. · 2014 to 2024
$23.5M
Techniques DevelopmentP2CHD086844 · NICHD · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI THOMPSON, AIKO · 2015 to 2024
$12.7M
COCA: Project 4. Neurocircuit Strategy to Decrease Cocaine Cue ReactivityP50DA046373 · NIDA · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI HANLON, COLLEEN A · 2019 to 2023
$9.9M
CSRD VA I01 CX000604NICHD NIH HHS P2C HD086844NIDA NIH HHS P50 DA046373NIGMS NIH HHS P20 GM109040RRD VA I01 RX003152
6 · The paper itself

Abstract

backgroundPrecise targeting of brain functional networks is believed critical for treatment efficacy of rTMS (repetitive pulse transcranial magnetic stimulation) in treatment resistant major depression.

objectiveTo use imaging data from a "failed" clinical trial of rTMS in Veterans to test whether treatment response was associated with rTMS coil location in active but not sham stimulation, and compare fMRI functional connectivity between those stimulation locations.

methodsAn imaging substudy of 49 Veterans (mean age, 56 years; range, 27-78 years; 39 male) from a randomized, sham-controlled, double-blinded clinical trial of rTMS treatment, grouping participants by clinical response, followed by group comparisons of treatment locations identified by individualized fiducial markers on structural MRI and resting state fMRI derived networks.

resultsThe average stimulation location for responders versus nonresponders differed in the active but not in the sham condition (P = .02). The average responder location derived from the active condition showed significant negative functional connectivity with the subgenual cingulate (P < .001) while the nonresponder location did not (P = .17), a finding replicated in independent cohorts of 84 depressed and 35 neurotypical participants. The responder and nonresponder stimulation locations evoked different seed based networks (FDR corrected clusters, all P < .03), revealing additional brain regions related to rTMS treatment outcome.

conclusionThese results provide evidence from a randomized controlled trial that clinical response to rTMS is related to accuracy in targeting the region within DLPFC that is negatively correlated with subgenual cingulate. These results support the validity of a neuro-functionally informed rTMS therapy target in Veterans.

Indexed as

Depressive Disorder, Treatment-ResistantTranscranial Magnetic StimulationBrainHumansMagnetic Resonance ImagingMaleMiddle AgedPrefrontal CortexTreatment OutcomeDepressionDorsolateral prefrontal cortexResting-state fMRI networksrTMSSubgenual cingulateTargeting

Identifiers

PMID33866020
PMCPMC8884259
OpenAlexW3154931169

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.