Maintenance Repetitive Transcranial Magnetic Stimulation (RTMS) in Relapse Prevention of Depression
Bibliographic record
Abstract
Depression is the most prevalent mental health condition with high morbidity and mortality. rTMS is an alternative treatment of acute depression validated in controlled trials. rTMS was approved by FDA for treatment of unipolar non-psychotic depression in patients who have failed one adequate antidepressant trial (Lisanby, 2009). Maintenance application of rTMS in depression remains under – researched. To investigate published evidence of maintenance rTMS in unipolar and bipolar depression. Systematic review of maintenance rTMS studies in unipolar and bipolar depression was conducted. An electronic search was carried out including The Cochrane Library, MEDLINE (1988-2014), EMBASE (1974-2014), and Psych Lit (1980-2014). References of selected articles were searched manually. English-language case reports, case series, cohort studies and controlled trials were selected. Studies reporting maintenance rTMS equal or less then 3 month were excluded. 8 case reports, 5 case series, 1 retrospective cohort study and 4 prospective open-label studies were critically appraised. No RCTs were available. Most patients reported had prolonged treatment-resistant depression. Considerable heterogeneity in maintenance rTMS frequency and parameters was observed. All studies reported short-term prolongation of remission period or preservation of acute treatment gains. Few rTMS studies reported longer-term maintenance treatment. rTMS appears to be a viable well-tolerated option for maintenance treatment of unipolar and bipolar depression either as monotherapy or as an adjunct to maintenance pharmacotherapy. Absence of consistent stimulation parameters makes it difficult to discuss rTMS relapse prevention effectiveness in systematic way. Large sample long-term sham control studies are needed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".