Evidence map›Paper›PMID 38482823›Full record

Trial reportPalliative medicine2024

Accelerated transcranial magnetic stimulation for psychological distress in advanced cancer: A phase 2a feasibility and preliminary efficacy clinical trial.

James Downar, Julie Lapenskie, Koby Anderson, Jodi Edwards, Christine Watt, Michel Dionne, Jill Rice, Monisha Kabir, Peter Lawlor, Jonathan Downar

Registry-linked trialOpen access · hybridAbstract readClinical Trial, Phase II
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Palliative medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04257227 (Transcranial Magnetic Stimulation for Psychological Distress in Patients With Advanced Illness), which is not on this map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
2.5field-weighted citation impact, top 11% 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.

NCT04257227 nacompletednot on this map

Transcranial Magnetic Stimulation for Psychological Distress in Patients With Advanced Illness: A Phase 2a/2b Dose-finding and Feasibility Clinical Trial

TypeinterventionalSponsorOttawa Hospital Research InstituteRan2020 to 2024Enrolled13ConditionsDepressive Symptoms, Depression, Anxiety, Psychological Distress, Terminal IllnessArmsrepetitive Transcranial Magnetic Stimulation (rTMS)
3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 10 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
  4. Review
  5. Review
  6. Mechanisms of Action of TMS in the Treatment of Depression.Current topics in behavioral neurosciences · 2024
    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

10 authors at 3 institutions in 1 country.

James DownarBruyère Research Institute, Ottawa, ON, Canada.ORCID 0000-0001-7479-1560
Julie LapenskieBruyère Research Institute, Ottawa, ON, Canada.ORCID 0000-0002-5358-5685
Koby AndersonBruyère Research Institute, Ottawa, ON, Canada.
Jodi EdwardsBruyère Research Institute, Ottawa, ON, Canada.
Christine WattBruyère Research Institute, Ottawa, ON, Canada.ORCID 0000-0002-6361-8815
Michel DionneBruyère Research Institute, Ottawa, ON, Canada.
Jill RiceBruyère Research Institute, Ottawa, ON, Canada.
Monisha KabirBruyère Research Institute, Ottawa, ON, Canada.ORCID 0000-0002-4456-7661
Peter LawlorBruyère Research Institute, Ottawa, ON, Canada.ORCID 0000-0001-7319-1395
Jonathan DownarTemerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Department of Psychiatry and Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
University of Ottawa · CACentre for Addiction and Mental Health · CAOttawa Hospital · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPsychological and existential suffering affects many people with advanced illness, and current therapeutic options have limited effectiveness. Repetitive transcranial magnetic stimulation (rTMS) is a safe and effective therapy for refractory depression, but no previous study has used rTMS to treat psychological or existential distress in the palliative setting.

aimTo determine whether a 5-day course of "accelerated" rTMS is feasible and can improve psychological and/or existential distress in a palliative care setting.

designOpen-label, single arm, feasibility, and preliminary efficacy study of intermittent theta-burst stimulation to the left dorsolateral prefrontal cortex, 600 pulses/session, 8 sessions/day (once per hour) for 5 days. The outcomes were the rates of recruitment, completion of intervention, and follow-up (Feasibility); and the proportion of participants achieving 50% improvement on the Hamilton Depression Rating Scale (HDRS) or Hospital Anxiety and Depression Scale (HADS) 2 weeks post-treatment (Preliminary Efficacy). SETTING/

participantsAdults admitted to our academic Palliative Care Unit with advanced illness, life expectancy >1 month and psychological distress.

resultsDue to COVID-19 pandemic-related interruptions, a total of nine participants were enrolled between August 2021 and April 2023. Two withdrew before starting rTMS, one stopped due to clinical deterioration unrelated to rTMS, and six completed the rTMS treatment. Five of six participants had a >50% improvement in HDRS, HADS-Anxiety, or both between baseline and the 2 week follow up; the sixth died prior to the 2-week follow-up. In this small sample, mean depression scores decreased from baseline to 2 weeks post-treatment (HDRS 18 vs 7,

conclusionsAccelerated rTMS improved symptoms of depression, anxiety, or both in this small feasibility and preliminary efficacy study. A larger, sham-controlled study is warranted to determine whether rTMS could be an effective, acceptable, and scalable treatment in the palliative setting.

trial registrationNCT04257227.

Indexed as

NeoplasmsTranscranial Magnetic StimulationAdultFeasibility StudiesHumansPandemicsTreatment Outcomeanxietydepressionend of life careexistential distresspalliative careTranscranial magnetic stimulation

Identifiers

PMID38482823
PMCPMC11025297
OpenAlexW4392810222

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

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.