Evidence map›Paper›PMID 42000069›Full record

Trial reportJournal of affective disorders2026

Repetitive transcranial magnetic stimulation (rTMS) for comorbid major depressive disorder and hoarding disorder: An open label pilot study.

Jessica J Zakrzewski, Lawrence G Appelbaum, Cory R Weissman, Yinming Sun, Catherine R Ayers, Zafiris J Daskalakis, Elizabeth W Twamley

Abstract readClinical Trial
In one paragraph

Trial report in Journal of affective disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

7 authors.

Jessica J ZakrzewskiDepartment of Psychiatry, UC San Diego, La Jolla, CA, United States; Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, United States. Electronic address: jzakrzewski@health.ucsd.edu.
Lawrence G AppelbaumDepartment of Psychiatry, UC San Diego, La Jolla, CA, United States.
Cory R WeissmanDepartment of Psychiatry, UC San Diego, La Jolla, CA, United States.
Yinming SunDepartment of Psychiatry, UC San Diego, La Jolla, CA, United States.
Catherine R AyersDepartment of Psychiatry, UC San Diego, La Jolla, CA, United States; Mental Health Care Line, VA San Diego Healthcare System, San Diego, CA, United States.
Zafiris J DaskalakisDepartment of Psychiatry, UC San Diego, La Jolla, CA, United States.
Elizabeth W TwamleyDepartment of Psychiatry, UC San Diego, La Jolla, CA, United States; Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, United States.

Funding

FELLOWSHIP IN GERIATRIC MENTAL HEALTHT32MH019934 · NIMH · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Elizabeth W Twamley · 1994 to 2026
$9.5M
Fellowship on Biological Psychiatry and NeuroscienceT32MH018399 · NIMH · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Pei-an (Betty) Shih · 1986 to 2026
$7.3M
NIMH NIH HHS T32 MH018399NIMH NIH HHS T32 MH019934RRD VA IK6 RX003504
6 · The paper itself

Abstract

backgroundHoarding Disorder (HD) is characterized by persistent difficulty discarding possessions due to a strong urge to save them, resulting in excessive clutter that compromises functioning. Despite the common prevalence and profound consequences of HD, there are no FDA approved treatments. Individuals with HD often have comorbid major depressive disorder (MDD). This study examined the feasibility and initial efficacy of repetitive transcranial magnetic stimulation (rTMS) for HD patients with comorbid MDD.

methodsParticipants with moderate or severe MDD and co-morbid HD underwent daily neuronavigated intermittent theta burst stimulation (iTBS) rTMS to the left dorsolateral prefrontal cortex for 20 sessions over four weeks. Assessments of symptoms and neuropsychological performance were collected at pre-treatment, post-treatment, and 1-month follow up.

resultsEleven individuals enrolled in the study (6 women; mean age 52). One participant dropped out after six sessions. Following iTBS treatment, depression symptoms on the Hamilton Depression Rating Scale-17 were reduced by 43% at post-treatment and 48% at follow-up. Hoarding symptoms on the Hoarding Rating Scale were reduced by 28% at post-treatment and 29% at follow-up, with the greatest reductions in difficulty discarding. Neuropsychological performance improvements were seen in attention/working memory, visual scanning, processing speed, and verbal learning (p < 0.05).

conclusionsThis is the first clinical trial of rTMS for MDD + HD and demonstrates preliminary feasibility and clinical improvement and the potential role for rTMS in HD treatment. Using rTMS to treat MDD in individuals with HD may open new avenues of care for this severe and undertreated disorder.

Indexed as

Hoarding DisorderMajor Depressive DisorderTranscranial Magnetic StimulationAdultAgedComorbidityDorsolateral Prefrontal CortexFemaleHumansMaleMiddle AgedNeuropsychological TestsPilot ProjectsTreatment OutcomeDepressionHoardingrTMSStimulationTreatment

Identifiers

PMID42000069
PMCPMC13159065

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.