Evidence map›Paper›PMID 36998170›Full record

Trial reportJournal of the Chinese Medical Association : JCMA2023

Effect of low-frequency repetitive transcranial magnetic stimulation as adjunctive treatment for insomnia patients under hypnotics: A randomized, double-blind, sham-controlled study.

Wei-Chen Lin, Mu-Hong Chen, Ying-Jay Liou, Pei-Chi Tu, Wen-Han Chang, Ya-Mei Bai, Cheng-Ta Li, Shih-Jen Tsai, Chen-Jee Hong, Tung-Ping Su

Open access · hybridAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of the Chinese Medical Association : JCMA, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing 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

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

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Review
  5. Review
  6. Article
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

10 authors at 3 institutions in 1 country.

Wei-Chen LinDepartment of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Mu-Hong ChenDepartment of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Ying-Jay LiouDepartment of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Pei-Chi TuDepartment of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Wen-Han ChangDivision of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
Ya-Mei BaiDepartment of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Cheng-Ta LiDepartment of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Shih-Jen TsaiDepartment of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Chen-Jee HongDepartment of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Tung-Ping SuDepartment of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
National Yang Ming Chiao Tung University · TWTaipei Veterans General Hospital · TWCheng Hsin General Hospital · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPharmacotherapy of insomnia is prescribed often but may be complicated by drug dependence. Cognitive-behavioral therapy for insomnia is effective, but requires time to take effect. Repetitive transcranial magnetic stimulation (rTMS) is effective for depression but of uncertain benefit for insomnia. We studied low-frequency rTMS of the left dorsal medial prefrontal cortex (DMPFC) as an adjunctive therapy of insomnia.

methodsWe recruited 60 patients with insomnia, of whom 49 completed the study. We applied 1 Hz rTMS to the DMPFC in the experimental group (n = 36) and sham coil for the placebo group (n = 13). Outcome measures included objective polysomnography (PSG) and subjective Pittsburgh Sleep Quality Index (PSQI). All participants were requested to continue prescribed pharmacotherapy.

resultsAfter 10 sessions of low-frequency DMPFC-rTMS, the experimental group demonstrated a reduction of duration of wake after sleep onset (WASO) from 75.4 (±53.3) to 51.2 (±75.1) min ( p = 0.011). Sleep efficiency (SE) increased from 74.6% (±15.6) to 80.8% (±13.8) ( p = 0.004). The sham group experienced improved SE from 79.4% (±30.7) to 88.9% (±5.6) ( p = 0.039). After controlling for baseline PSG parameters and hypnotic dosage, the sham group exhibited better effects of sleep onset latency and SE than the rTMS group but no difference on PSQI.

conclusionAlthough the effects of rTMS and sham coil on insomnia were similar (which implied significant placebo effect), low-frequency DMPFC-rTMS might offer a safe, non-invasive, and useful adjunctive therapy of insomnia by reducing WASO. The DMPFC may represent a new target for future rTMS insomnia studies.

Indexed as

Sleep Initiation and Maintenance DisordersTranscranial Magnetic StimulationDouble-Blind MethodHumansOutcome Assessment, Health CarePolysomnographyPrefrontal CortexTreatment Outcome

Identifiers

PMID36998170
PMCPMC12755586
OpenAlexW4362459305

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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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.