Evidence map›Paper›PMID 40264519›Full record

ArticleFrontiers in psychiatry2025

Impact of repetitive transcranial magnetic stimulation on clinical and cognitive outcomes, and brain-derived neurotrophic factor levels in treatment-resistant depression.

Enrico Ginelli, Lucia Sanna, Pasquale Paribello, Ulker Isayeva, Giorgio Corona, Clement C Zai, Daniela Manca, Maria Novella Iaselli, Roberto Collu, Federica Pinna and 4 more

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In one paragraph

Article in Frontiers in psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–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 synthesis or guideline pooled it.

  1. Pooled it
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

14 authors.

Enrico GinelliSection of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
Lucia SannaSection of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
Pasquale ParibelloSection of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
Ulker IsayevaSection of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
Giorgio CoronaCenter for Transcranial Magnetic Stimulation, Cagliari, Italy.
Clement C ZaiTanenbaum Centre for Pharmacogenetics, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.
Daniela MancaSection of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
Maria Novella IaselliSection of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
Roberto ColluDepartment of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy.
Federica PinnaSection of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
Maria SchermaDepartment of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy.
Mirko ManchiaSection of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
Paola FaddaDepartment of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy.
Bernardo CarpinielloSection of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Treatment-resistant depression (TRD) affects approximately 30% of patients with major depressive disorder (MDD), for whom effective treatment options are limited. Repetitive transcranial magnetic stimulation (rTMS) has shown efficacy in alleviating depressive symptoms in TRD. However, it remains unclear if these improvements are driven or mediated by changes in cognitive function or biological markers, such as brain-derived neurotrophic factor (BDNF). Methods: This study examines the effects of rTMS on depressive symptoms, cognition, and BDNF levels, as well as the potential moderating role of lifetime suicidal attempts (LSA) on cognition and the predictive value of baseline BDNF for clinical outcomes. Twenty-five TRD patients were included, with 13 in the rTMS treatment group (receiving 20 sessions of rTMS over four weeks) and 12 as control group. Depression severity, cognitive function (Mini-Mental State Examination, Verbal Fluency, Digit Span), and serum BDNF levels were measured pre- and post-treatment. Mixed-effects linear regression models assessed clinical and biological associations. Results: rTMS significantly reduced HAM-D (p < 0.001) and CGI (p < 0.001) scores compared to controls. Cognitive performance improved significantly in MMSE (p = 0.049) and Digit Span (p = 0.04), with no significant changes in BDNF levels (p = 0.39). LSA did not moderate cognitive outcomes, and baseline BDNF did not predict clinical improvement (p = 0.68). Discussion: rTMS reduced depressive symptoms in TRD patients, with modest cognitive benefits. Baseline BDNF did not predict outcomes, though the lack of significant change suggests complex neuroplastic responses. Future studies should include larger samples and refined biomarker assessments.

Indexed as

BDNFdepressionneuroplasticityrTMSsuicidalitytreatment-resistance

Identifiers

PMID40264519
PMCPMC12011827

What Socratic holds

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Registered trials

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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 Socratic graph.