Effects of Personalized Transcranial Magnetic Stimulation on Social Cognitive Network Functional Connectivity in Schizophrenia Spectrum Disorders
Bibliographic record
Abstract
Although it has been suggested that repetitive transcranial magnetic stimulation (rTMS) may be associated with greater placebo responses than other treatments, the magnitude of the effect of patient expectations on treatment outcomes has not been previously explored in a prospective fashion.The presenter will share the results of a single-center study of 208 patients with treatment resistant depression (TRD) receiving a 4-6 course of once daily high-frequency rTMS delivered to the left dorsolateral prefrontal cortex at 120% of the individualized resting motor threshold.Before starting open-label rTMS treatment, participants completed the Stanford Expectation of Treatment Scale (SETS), which includes measures of positive (placebo) and negative (nocebo) anticipated effects, as well as mean positivity bias score (positive expectancy minus negative expectancy subscale averages).Physicians were blinded to SETS scores and all participants were rTMS nave.Primary outcomes were antidepressant response (>50% reduction in the Hamilton Depression Rating Scale (HAMD-17) from pre-treatment to the end the acute course), remission of depressive symptoms (HAMD-17 score < 7), and premature discontinuation of rTMS.The mean positivity bias score was 0.48 2.21, indicating the cohort was overall neutral regarding their expectations of the treatment.There was a weak association between pre-treatment SETS scores and baseline HAMD-17, but expectations impacted rTMS outcomes at the end of treatment.Higher pre-treatment positive expectations were associated with greater odds of remission (OR 1.90, p 0.003) and greater reduction in HAMD-17 scores (b 1.30, p 0.005), after adjusting for covariates.Negative expectancy was not associated with decreased odds of remission or treatment discontinuation.Implications of these findings in the context of the existing literature of the effects of expectations on clinical outcomes to other forms of neuromodulation and the potential shared neurobiological mechanisms between placebo effects and neural network modulation by rTMS will be discussed.
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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 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| 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".