Evidence map›Paper›PMID 42267155›Full record

ArticleFrontiers in psychiatry2026

Factors associated with treatment-emergent headache occurrence following RTMS to non-motor areas and the impact on treatment outcomes: a retrospective study.

Gauri Gusain, Thomas E Valles, Margaret G Distler, Evan H Einstein, Nathaniel D Ginder, Ralph J Koek, David E Krantz, Michael K Leuchter, Hanadi A Oughli, Aaron Slan and 5 more

Abstract read
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In one paragraph

Article in Frontiers in psychiatry, 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

15 authors.

Gauri GusainTMS Clinical and Research Service, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at University of California, Los Angeles (UCLA), Los Angeles, CA, United States.
Thomas E VallesTMS Clinical and Research Service, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at University of California, Los Angeles (UCLA), Los Angeles, CA, United States.
Margaret G DistlerTMS Clinical and Research Service, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at University of California, Los Angeles (UCLA), Los Angeles, CA, United States.
Evan H EinsteinTMS Clinical and Research Service, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at University of California, Los Angeles (UCLA), Los Angeles, CA, United States.
Nathaniel D GinderTMS Clinical and Research Service, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at University of California, Los Angeles (UCLA), Los Angeles, CA, United States.
Ralph J KoekTMS Clinical and Research Service, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at University of California, Los Angeles (UCLA), Los Angeles, CA, United States.
David E KrantzTMS Clinical and Research Service, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at University of California, Los Angeles (UCLA), Los Angeles, CA, United States.
Michael K LeuchterTMS Clinical and Research Service, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at University of California, Los Angeles (UCLA), Los Angeles, CA, United States.
Hanadi A OughliTMS Clinical and Research Service, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at University of California, Los Angeles (UCLA), Los Angeles, CA, United States.
Aaron SlanTMS Clinical and Research Service, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at University of California, Los Angeles (UCLA), Los Angeles, CA, United States.
Thomas StrouseTMS Clinical and Research Service, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at University of California, Los Angeles (UCLA), Los Angeles, CA, United States.
Scott A WilkeTMS Clinical and Research Service, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at University of California, Los Angeles (UCLA), Los Angeles, CA, United States.
Alexander S YoungTMS Clinical and Research Service, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at University of California, Los Angeles (UCLA), Los Angeles, CA, United States.
Andrew F LeuchterTMS Clinical and Research Service, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at University of California, Los Angeles (UCLA), Los Angeles, CA, United States.
Juliana CorlierTMS Clinical and Research Service, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at University of California, Los Angeles (UCLA), Los Angeles, CA, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Repetitive Transcranial Magnetic Stimulation (rTMS) is an FDA-approved, non-invasive treatment for Major Depressive Disorder (MDD). rTMS has a favorable safety profile, however, headaches are a common side effect. It is unclear which patients may be at greatest risk for headache, which device parameters might be associated with headache, and whether occurrence of headaches during rTMS affects eventual treatment outcome. Methods: This retrospective study analyzed clinical records from 938 patients who received rTMS treatment between 2017 and 2023. Patients were categorized based on whether they reported treatment-emergent headaches during the first 15 sessions. We assessed associations between headache occurrence and stimulation parameters (motor threshold, stimulation intensity), as well as patient characteristics (age, gender, baseline depression severity). Depression outcomes were measured using the Inventory of Depressive Symptomatology IDS. Results: Treatment-emergent headaches occurred more frequently in younger patients (p = 0.03) and women (p = 0.001), with no differences in headache occurrence observed across stimulation parameters. Patients who reported headaches had higher baseline depression scores (p = 0.0008) and maintained slightly elevated symptoms throughout treatment. Headache occurrence did not significantly affect overall clinical response rates but was associated with improved treatment retention. Conclusions: Treatment-emergent headaches during rTMS appear more closely linked to patient specific characteristics, such as age, gender, and depression severity rather than stimulation parameters. While the occurrence of headaches is common, they had no impact on clinical outcomes and can improve retention if correctly managed. We recommend providing individualized patient support during the early phase of treatment to improve adherence and enhance patient experience.

Indexed as

depressionheadachesneurostimulationside effectsTranscranial Magnetic Stimulation (TMS)

Identifiers

PMID42267155
PMCPMC13243363

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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.