Evidence map›Paper›PMID 40847007›Full record

Observational studyMolecular psychiatry2026

Predictive value of subgenual cingulate normative connectivity to TMS treatment site for antidepressant response in routine clinical practice: a prospective, multisite cohort study.

Sanaz Khosravani, Stephan T Palm, William Drew, Summer B Frandsen, Christopher Lin, Eric Tirrell, Lauren Hindley, Molly Schineller, Arun Garimella, Nicole Chiulli and 10 more

Registry-linked trialAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Molecular psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03276793 (Using Human Brain Connectivity to Identify the Causal Neuroanatomical Substrate of Depression Symptoms), which is not on this map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 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.

NCT03276793 narecruitingnot on this map

Using Human Brain Connectivity to Identify the Causal Neuroanatomical Substrate of Depression Symptoms

TypeinterventionalSponsorBrigham and Women's HospitalRan2018 to 2027Enrolled260ConditionsDepressionArmsMRI scan, Behavioral testing
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Task-guided accelerated cTBS simultaneously treats depression and social dysfunction in patients with major depressive disorder: a randomized clinical trial.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026
    Trial
  3. Article
  4. Article
  5. Review
  6. Article
  7. 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

20 authors.

Sanaz KhosravaniCenter for Brain Circuit Therapeutics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. skhosravani@mgb.org.ORCID http://orcid.org/0009-0008-2469-5325
Stephan T PalmCenter for Brain Circuit Therapeutics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.ORCID http://orcid.org/0009-0000-8345-5470
William DrewCenter for Brain Circuit Therapeutics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.ORCID http://orcid.org/0000-0002-9178-8731
Summer B FrandsenCenter for Brain Circuit Therapeutics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.ORCID http://orcid.org/0000-0003-0306-3018
Christopher LinCenter for Brain Circuit Therapeutics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Eric TirrellButler Hospital TMS Clinic and Neuromodulation Research Facility, Providence, RI, USA.
Lauren HindleyButler Hospital TMS Clinic and Neuromodulation Research Facility, Providence, RI, USA.
Molly SchinellerDepartment of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Arun GarimellaCenter for Brain Circuit Therapeutics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Nicole ChiulliCenter for Brain Circuit Therapeutics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
David LawsonCenter for Brain Circuit Therapeutics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Emma JonesCenter for Brain Circuit Therapeutics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Daniel Z PressDepartment of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Adam P SternDepartment of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Joshua C BrownMcLean Hospital, Harvard Medical School, Belmont, MA, USA.
Tracy A BarbourDepartment of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Joseph J TaylorCenter for Brain Circuit Therapeutics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.ORCID http://orcid.org/0000-0002-9185-0427
Linda L CarpenterButler Hospital TMS Clinic and Neuromodulation Research Facility, Providence, RI, USA.ORCID http://orcid.org/0000-0002-9651-3307
Shan H Siddiqi *Center for Brain Circuit Therapeutics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.ORCID http://orcid.org/0000-0002-0967-9289
Michael D Fox *Center for Brain Circuit Therapeutics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. mdfox@bwh.harvard.edu.ORCID http://orcid.org/0000-0001-8848-6399

Funding

Neuroimaging and Neuromodulation CoreP20GM130452 · NIGMS · BUTLER HOSPITAL (PROVIDENCE, RI) · PI VAN 'T WOUT-FRANK, MASCHA · 2019 to 2023
$11.3M
Using human brain connectivity to identify the causal neuroanatomical substrate of depression symptomsR01MH113929 · NIMH · BRIGHAM AND WOMEN'S HOSPITAL · PI MICHAEL D FOX · 2017 to 2026
$6.9M
NIGMS NIH HHS P20 GM130452NIMH NIH HHS R01 MH113929
6 · The paper itself

Abstract

Small single-site studies found that transcranial magnetic stimulation (TMS) targets with better antidepressant response were more negatively functionally connected to the subgenual cingulate cortex (SGC). These led to "anti-subgenual" TMS targeting in recent clinical trials. We conducted a larger prospective multi-site observational study to test the robustness of this observation in more diverse clinical populations. Sixty-six treatment-seeking individuals with major depressive disorder (MDD) received 3-8 weeks of daily rTMS to the left dorsolateral prefrontal cortex using scalp-based targeting as part of standard clinical care. Stimulation sites were recorded with MRI neuronavigation on multiple days. Our primary outcome was the correlation between change in Beck Depression Inventory (BDI-II) score and connectivity of each individual's TMS site to the SGC, computed using resting-state functional connectivity data from 1000 healthy individuals. Secondary (post hoc) analyses incorporated additional clinical covariates. No relationship was found between antidepressant response and normative connectivity of TMS site to SGC (r = 0.1, p = 0.39). This was not due to inconsistency in the location of the TMS sites, which showed smaller within- than between-individual variance (p < 0.0001). Post hoc analyses showed significant associations when adding clinical covariates (r = -0.27, p = 0.014). Baseline anxiety (p < 0.0001) and comorbid psychiatric conditions (p < 0.001) accounted for the most variance in response. Atlas-based connectivity of TMS site to the SGC accounted for minimal variance in antidepressant response in this diverse sample. The "anti-subgenual" target derived based on normative connectome may be suboptimal for MDD patients with high baseline anxiety or psychiatric comorbidities.

trial registrationClinicalTrials.gov Identifier: NCT03276793.

Indexed as

Gyrus CinguliMajor Depressive DisorderTranscranial Magnetic StimulationAdultAntidepressive AgentsCohort StudiesDorsolateral Prefrontal CortexFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedPrefrontal CortexProspective StudiesPsychiatric Status Rating ScalesTreatment OutcomeAntidepressive AgentsFunctional connectivityMajor depressive disorderNetwork mappingSubgenual cingulateTranscranial magnetic stimulation

Identifiers

PMID40847007
PMCPMC13123512

What OpenQuestion holds

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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.