Evidence map›Paper›PMID 42540338›Full record

ArticleBiological psychiatry global open science2026

Prospective Development of a Whole-Brain Connectivity and Electric Field-Guided Transcranial Magnetic Stimulation Atlas for Posttraumatic Stress Disorder Symptoms.

Sneha Chandrashekar, Grant Brighter, Ivy Sun, Hannah Gura, Milan Patel, David F Gregory, Kevin G Lynch, Audreyana Jagger-Rickels, Desmond J Oathes, Yvette I Sheline and 5 more

Abstract read
In one paragraph

Article in Biological psychiatry global open science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

15 authors.

Sneha ChandrashekarCenter for Neuromodulation in Depression and Stress, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania.
Grant BrighterCenter for Neuromodulation in Depression and Stress, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania.
Ivy SunCenter for Neuromodulation in Depression and Stress, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania.
Hannah GuraCenter for Neuromodulation in Depression and Stress, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania.
Milan PatelCenter for Neuromodulation in Depression and Stress, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania.
David F GregoryCenter for Neuromodulation in Depression and Stress, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania.
Kevin G LynchDepartment of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania.
Audreyana Jagger-RickelsNational Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts.
Desmond J OathesCenter for Neuromodulation in Depression and Stress, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania.
Yvette I ShelineCenter for Neuromodulation in Depression and Stress, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania.
Lily BrownCenter for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania.
William P MilbergDepartment of Psychiatry, Chobanian and Avedisian School of Medicine, Boston University, Boston, Massachusetts.
Catherine B FortierDepartment of Psychiatry, Chobanian and Avedisian School of Medicine, Boston University, Boston, Massachusetts.
Michael EstermanNational Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts.
Nicholas L BalderstonCenter for Neuromodulation in Depression and Stress, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania.

Funding

Novel electric-field modelling approach to quantify changes in resting state functional connectivity following theta burst stimulationU01MH130447 · NIMH · UNIVERSITY OF PENNSYLVANIA · PI BALDERSTON, NICHOLAS LEE · 2022 to 2025
$2.2M
Novel electric-field modelling approach to quantify changes in resting state functional connectivity following theta burst stimulationUF1MH130447 · NIMH · UNIVERSITY OF PENNSYLVANIA · PI BALDERSTON, NICHOLAS LEE · 2025 to 2025
$1.5M
CSRD VA I01 CX001653NIMH NIH HHS U01 MH130447NIMH NIH HHS UF1 MH130447
6 · The paper itself

Abstract

Background: Although trauma-focused psychotherapy remains the first-line treatment for posttraumatic stress disorder (PTSD), 14% to 35% of individuals with PTSD fail to achieve symptom remission. Transcranial magnetic stimulation (TMS) has shown promise as an adjunctive intervention, but its efficacy for PTSD remains inconsistent and may be better informed by the incorporation of brain-based signals to guide stimulation. To address this, we developed a connectivity-based modeling framework to identify functional networks that predict symptom severity and to estimate where stimulation would most effectively reduce PTSD symptoms. Methods: We used clinical, structural, and resting-state functional data from 350 veterans with and without PTSD. Principal component analysis (PCA) was applied to functional connectivity matrices to reduce dimensionality, and resulting component scores were entered into a least absolute shrinkage and selection operator regression to identify connections associated with symptom severity. To simulate TMS effects, we generated electric field models for 200 randomly distributed cortical sites per participant and used these distributions to estimate connectivity changes proportional to the modeled fields. The estimated changes were combined with PCA regression weights to predict stimulation-induced symptom changes at each site and were mapped across the cortex to create a whole-brain TMS targeting atlas. Results: The model identified 2 broad and opposing patterns. Stimulation expected to increase connectivity in the left prefrontal cortex was predicted to reduce symptoms, whereas stimulation expected to decrease connectivity in bilateral parietal and occipital regions was also predicted to reduce symptoms. Conclusions: These findings provide a framework for individualized TMS targeting in PTSD and generate potential therapeutic targets for future clinical trials.

Indexed as

CAPSE-field monitoringPrecision medicinePTSDrs-fMRITMS

Identifiers

PMID42540338
PMCPMC13425816

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.