Evidence map›Paper›PMID 39604433›Full record

Trial reportScientific reports2024

Intermittent theta burst stimulation over the left prefrontal cortex: no additional effect for virtual reality exposure therapy in acrophobia-a randomized trial.

L M Cybinski, B Bohmeier, K Rolle, D Gromer, T Raij, F Gundelach, A Erhardt-Lehmann, A Mühlberger, J Deckert, T Polak and 2 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Scientific reports, 2024. 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
–field-weighted citation impact
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.

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

12 authors.

L M CybinskiCenter of Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Wuerzburg, 97080, Wuerzburg, Germany.
B BohmeierCenter of Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Wuerzburg, 97080, Wuerzburg, Germany.
K RolleInstitute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, 72076, Tübingen, Germany.
D GromerDepartment of Psychology - Clinical Psychology and Psychotherapy, University of Wuerzburg, 97070, Wuerzburg, Germany.
T RaijMGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, 02129, USA.
F GundelachCenter of Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Wuerzburg, 97080, Wuerzburg, Germany.
A Erhardt-LehmannCenter of Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Wuerzburg, 97080, Wuerzburg, Germany.
A MühlbergerDepartment of Psychology - Clinical Psychology and Psychotherapy, University of Regensburg, 93053, Regensburg, Germany.
J DeckertCenter of Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Wuerzburg, 97080, Wuerzburg, Germany.
T PolakCenter of Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Wuerzburg, 97080, Wuerzburg, Germany.
P PauliDepartment of Psychology - Clinical Psychology and Psychotherapy, University of Wuerzburg, 97070, Wuerzburg, Germany.
M J HerrmannCenter of Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Wuerzburg, 97080, Wuerzburg, Germany. Herrmann_M@ukw.de.

Funding

Re-Wiring the Human BrainR01NS126337 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI Tommi Raij · 2022 to 2026
$3.4M
NINDS NIH HHS R01 NS126337
6 · The paper itself

Abstract

Anxiety disorders are the most prevalent mental health conditions. Besides psycho-pharmacotherapy, cognitive behavioral therapy with an exposure-based approach is considered the gold standard. However, not all patients benefit from this approach. Here, we aimed to translate laboratory findings on enhanced fear extinction with repetitive transcranial magnetic stimulation (TMS) to the clinic. In this double-blind, randomized, placebo-controlled clinical trial, 76 participants with acrophobia received an activating intermittent theta burst stimulation (iTBS) targeting the left posterior prefrontal cortex immediately before two virtual reality exposure therapy sessions. Phobic symptoms were assessed at baseline, post-intervention, and a 6-month follow-up. Results revealed a significant reduction in phobic symptoms from baseline to post-assessment and follow-up and confirmed the efficacy of virtual reality exposure therapy as a treatment for specific phobias. Interestingly, no additional effect was observed for active iTBS compared to sham iTBS. Our post-hoc analyses argue for an individualized TMS application. Further research is needed to determine optimal TMS parameters and validate these results in clinical trials, accounting for methodological and inter- and intra-individual variability, as well as alternative therapeutic processes.

Indexed as

Phobic DisordersPrefrontal CortexVirtual Reality Exposure TherapyAdultDouble-Blind MethodFemaleHumansMaleMiddle AgedTheta RhythmTranscranial Magnetic StimulationTreatment OutcomeYoung Adult

Identifiers

PMID39604433
PMCPMC11603325

What OpenQuestion holds

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Registered trials

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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.