ArticleFrontiers in psychiatry2022
Sex/Gender as a Factor That Influences Transcranial Magnetic Stimulation Treatment Outcome: Three Potential Biological Explanations.
Article in Frontiers in psychiatry, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it, 71 citations in OpenAlex.
- The effectiveness and safety of repetitive transcranial magnetic stimulation on spasticity after upper motor neuron injury: A systematic review and meta-analysis.Frontiers in neural circuits · 2022Pooled it
- Brain oscillation-synchronized stimulation for major depression: a randomized controlled trial comparing EEG-triggered repetitive TMS with standard iTBS (Acronym: BOSSFRONT2).European archives of psychiatry and clinical neuroscience · 2026Trial
- Personalized fMRI-Guided TMS Targeting the Threat Neurocircuitry in PTSD: A Randomized Clinical Trial.The American journal of psychiatry · 2026Trial
- A Randomized Controlled Trial of Medial Prefrontal Cortex Theta Burst Stimulation for Cocaine Use Disorder: A Three-Month Feasibility and Brain Target Engagement Study.Biological psychiatry. Cognitive neuroscience and neuroimaging · 2025Trial
- Sex Differences in Scalp-to-Cortex Distance: Implications for Transcranial Magnetic Stimulation Efficacy in Alcohol Use Disorder.Alcohol, clinical & experimental research · 2026Article
- Real-world evidence of SAINT® effectiveness in a heterogenous clinical population with psychiatric and medical comorbidities: A multicenter, open-label, community-based study.Journal of mood and anxiety disorders · 2026Article
- Females have shorter scalp-to-cortex distances and receive stronger TMS electrical fields: Implications for clinical treatment.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026Article
- The Impact of Sex Hormones on Transcranial Magnetic Stimulation Against the Oxidative Stress in the Pathogenesis of Multiple Sclerosis.Biomolecules · 2025Article
- Developing a reverse translational model of low-intensity rTMS in alcohol use disorder: The influence of theta burst stimulation protocols on binge alcohol drinking in mice.Transcranial magnetic stimulation (2024) · 2025Article
- Predictive modeling of response to repetitive transcranial magnetic stimulation in treatment-resistant depression.Translational psychiatry · 2025Article
- Targeting VMPFC-amygdala circuit with TMS in substance use disorder: A mechanistic framework.Addiction biology · 2025Article
- Comparing the effect of transcranial random noise stimulation and transcranial direct current stimulation over the motor cortex on motor performance in men vs. women: a randomized controlled crossover study.Frontiers in human neuroscience · 2025Article
- Neuromodulation of Fear and Anxiety Circuits.Current topics in behavioral neurosciences · 2025Review
- Individuals with psychosis receive less electric field strength during transcranial direct current stimulation compared to healthy controls.Schizophrenia (Heidelberg, Germany) · 2024Article
- A causal role of the right dorsolateral prefrontal cortex in random exploration.Scientific reports · 2024Article
- Sex differences in laterality of motor unit firing behavior of the first dorsal interosseous muscle in strength-matched healthy young males and females.European journal of applied physiology · 2024Article
- Effects of routine repetitive transcranial magnetic stimulation on the sleep duration of patients with treatment-resistant depression: A prospective cohort study.PCN reports : psychiatry and clinical neurosciences · 2024Article
- Differences in scalp-to-cortex tissues across age groups, sexes and brain regions: Implications for neuroimaging and brain stimulation techniques.Neurobiology of aging · 2024Article
- Neuromodulation for Cannabis Use: A Scoping Review.Brain sciences · 2024Article
- rTMS for Co-occurring Psychiatric and Substance Use Disorders: Narrative Review and Future Directions.Current addiction reports · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation technique which is now being used in psychiatry clinics across the world as a therapeutic tool for a variety of neural-circuit based disorders (e.g., major depression, obsessive compulsive disorder, substance use disorders, post-traumatic stress disorder, headache, pain). The higher volume of use and publication of multiple large-scale clinical trials has provided researchers with a unique opportunity to retrospectively evaluate factors influencing TMS treatment responses in large samples of patients. While many studies have focused on TMS protocol parameters as moderators of treatment efficacy, sex/gender is another critical, often overlooked factor influencing TMS treatment outcome. Women, especially during periods of high estradiol, appear to be particularly sensitive to the therapeutic effects of rTMS. This manuscript makes a case for three potential biological explanations for these findings. Drawing on literature from cranio-facial anatomy, neuroimaging, and neuroendocrine fields, we posit that observed increases in response rates of women in clinical rTMS trials may be related to: (1) Closer proximity of the brain to the scalp at the prefrontal cortex, leading to larger TMS induced electric fields especially at the medial prefrontal cortex, (2) Greater gray matter density and gyrification in the prefrontal cortex, and (3) High levels of estradiol which facilitate cortical excitability. These biological explanations are empirical ideas which have been evaluated in laboratory studies and lend themselves to prospective evaluation in multisite clinical rTMS trials. The existing literature on this topic and these three potential biological explanations all indicate that the TMS field should routinely evaluate sex/gender (and associated biological metrics like scalp-to-cortex distance, gray matter density, estradiol/progesterone levels) as a factor that may influence treatment outcome.
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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.