Evidence map›Paper›PMID 36606675›Full record

ArticleTopics in stroke rehabilitation2023

Feasibility of performing a multi-arm clinical trial examining the novel combination of repetitive transcranial magnetic stimulation and aerobic exercise for post-stroke depression.

Ryan E Ross, Catherine J VanDerwerker, Mark S George, Chris M Gregory

Open access · greenAbstract read
In one paragraph

Article in Topics in stroke rehabilitation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
1.0field-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.

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

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. 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

4 authors at 1 institution in 1 country.

Ryan E RossResearch Service, Ralph H. Johnson Veterans Affairs Health Care System, Charleston, SC, USA.ORCID 0000-0002-8483-8884
Catherine J VanDerwerkerDepartment of Health Sciences and Research, Medical University of South Carolina, Charleston, SC, USA.ORCID 0000-0001-7607-1989
Mark S GeorgeResearch Service, Ralph H. Johnson Veterans Affairs Health Care System, Charleston, SC, USA.
Chris M GregoryResearch Service, Ralph H. Johnson Veterans Affairs Health Care System, Charleston, SC, USA.
Medical University of South Carolina · 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 GEORGE, MARK S · 2015 to 2024
$12.7M
Age-related changes in neuroplasticity impede recovery in post-stroke depression: a novel exercise and brain stimulation paradigm to prime neuroplastic potentialIK1RX002962 · VA · RALPH H JOHNSON VA MEDICAL CENTER · PI ROSS, RYAN · 2019 to 2020
–
NICHD NIH HHS P2C HD086844NIGMS NIH HHS P20 GM109040RRD VA IK1 RX002962
6 · The paper itself

Abstract

backgroundPost-stroke depression (PSD) occurs in approximately one-third of chronic stroke survivors. Although pharmacotherapy reduces depressive symptoms, side effects are common and stroke survivors have increased likelihood of multimorbidity and subsequent polypharmacy. Thus, alternative non-pharmacological treatments are needed. Combining two non-pharmacological anti-depressant treatments, aerobic exercise (AEx) and repetitive transcranial magnetic stimulation (rTMS), has been demonstrated to be feasible and well-tolerated in chronic stroke survivors.

objectivesThe purpose of this trial was to determine the feasibility of conducting a multi-arm combinatorial trial of rTMS and AEx and to provide an estimate of effect size of rTMS+AEx on PSD symptoms.

methodsTwenty-four participants were allocated to one of four treatment arms AEx, rTMS, rTMS+AEx, or non-depressed Control receiving AEx. All participants received a total of 24 treatment sessions. Participant adherence was the primary outcome measure for feasibility and within group effect sizes in Patient Health Questionnaire-9 (PHQ-9) score was the primary outcome for preliminary efficacy.

resultsMean adherence rates to the exercise intervention for AEx, rTMS+AEx, and Control subjects were 83%, 98%, and 95%, respectively. Mean adherence rates for rTMS and rTMS+AEx subjects were 97% and 99%, respectively. The rTMS and rTMS+AEx treatment groups demonstrated clinically significant reductions of 10.5 and 6.2 points in PHQ-9 scores, respectively.

conclusionPerforming a multi-arm combinatorial trial examining the effect of rTMS+AEx on PSD appears feasible. All treatment arms demonstrated strong adherence to their respective interventions and were well received. rTMS and the combination of AEx with rTMS may be alternative treatments for PSD.

Indexed as

StrokeBrain Damage, ChronicDepressionExerciseFeasibility StudiesHumansTranscranial Magnetic StimulationTreatment Outcomeaerobic exercisedepressionpost-stroke depression: repetitive transcranial magnetic stimulation (rTMS)rehabilitationStroke

Identifiers

PMID36606675
PMCPMC10323040
OpenAlexW4313649561

What OpenQuestion holds

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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.