ArticleFrontiers in psychiatry2025
Effect of TMS laterality on clinical outcomes in treatment resistant depression patients with comorbid anxiety - a retrospective study.
Article in Frontiers in psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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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.
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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.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Functional brain alterations in anxious depression: Insights from whole-brain fMRI and meta-analysis.Dialogues in clinical neuroscience · 2026Pooled it
- Circuit-targeted modulation of anxiety symptoms in individuals with major depression: A randomized head-to-head TMS trial.Molecular psychiatry · 2026Trial
- Immunotherapy for depression: targeting cytokine pathways in major depressive disorder.Psychopharmacology · 2026Review
- Impact of Comorbid Generalized Anxiety Disorder on rTMS/iTBS Clinical Outcomes in Major Depression: A Multicenter Registry-Based Observational Study.Journal of personalized medicine · 2026Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objectives: High-frequency repetitive transcranial magnetic stimulation (rTMS) of the left-hemisphere dorsolateral prefrontal cortex (DLPFC) is FDA cleared for the treatment of adult treatment-resistant major depressive disorder (MDD). Though off-label, sequential bilateral stimulation (SBS), which combines high-frequency left-hemisphere and low-frequency right-hemisphere DLPFC stimulation, is offered in various clinics to treat depression with comorbid anxiety. Few systematic studies investigate the comparative efficacy of the SBS protocol versus the FDA-label protocol for the clinical management of depression with comorbid anxiety. The objective of the current study was to compare the efficacy of HF-LUS to that of SBS within a clinical setting where both are offered to patients with anxious depression. Based on both theories of the pathophysiology of anxious depression as well as clinical practice, we hypothesized that SBS would result in greater symptom reduction as compared to HF-LUS. Methods: This open label, retrospective cohort study included 86 patients with MDD and comorbid anxiety who received either high frequency left unilateral stimulation (HF-LUS) (n=44) or SBS (n=42). Patient Health Questionnaire 9 (PHQ9), General Anxiety Disorder 7 (GAD7) questionnaire, a self-reported depression (SRD) Likert scale, and a self-reported anxiety (SRA) Likert scale were used to quantify changes in depressive and anxiety symptoms. Results: Inconsistent with our hypothesis, both groups saw a significant improvement in depression and anxiety symptoms with no difference in course nor degree of improvement. Improvements in depression and anxiety were significantly positively correlated in both bilateral and unilateral cohorts. Conclusions: Bilateral rTMS may not provide any additional therapeutic advantages over the standard FDA-cleared left unilateral rTMS protocol for anxious depressive patients.
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