Effectiveness of unilateral vs. bilateral rTMS treatment on suicidal ideation in patients with depression and comorbid anxiety
Bibliographic record
Abstract
Background: Transcranial Magnetic Stimulation (TMS) can significantly improve depression acutely in those with treatment-resistant depression (TRD).However, relapse is not uncommon, with 20% relapsing in 6 months and nearly 40% relapsing within a year.Cranial electrotherapy stimulation (CES) is FDA-cleared for depressive symptoms, but has not been assessed after TMS to improve maintenance in TRD.Objective: To assess the tolerability of home-based CES in TRD after treatment with TMS, and to assess whether the benefits of TMS can be extended with CES over 8 weeks.Design: This was a prospective open label study over 8 weeks with 10 patients.Patients with response to TMS as defined by at least a 50% improvement on the PHQ9 were offered CES for 8 weeks at home.Their PHQ9 scores at the end of 8 weeks were compared to their PHQ9 scores at the end of TMS treatment.Results: Before TMS, the mean PHQ9 score was 19.89, and the mean score after TMS was 4.67.The mean score after CES was 5.33 (5.0 with intent to treat, LOCF).Using the t-test for 2 dependent means, t ¼ 0.65 and p ¼ 0.53, indicating no significant difference between mean PHQ9 score at the end of TMS treatment and mean PHQ9 score at the end of CES treatment.7/9 (78%) of patients who achieved response and 3/4 (75%) of patients who achieved remission at the end of TMS were able to maintain their status with CES. 1 patient dropped out due to intolerability (1/10, 10%).Conclusion: CES was tolerable in TRD after TMS for most patients.Further, patients on average were able to maintain benefits of their TMS treatment with at-home CES for 8 weeks.Future studies should use a randomized controlled design with a sham arm to build upon this pilot study data.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".