Identifying poor responders to repetitive transcranial magnetic stimulation using structural brain networks.

Lower strength and organization in two structural-network measures were associated with poorer response and remission after rTMS. This may help future treatment planning, but it is not yet a validated test for deciding who should receive treatment.

Li Y, Wang M, Han W, Wei H, Zhu Y, Xu Y.
Progress in neuro-psychopharmacology & biological psychiatry · Publication date: 2026-09-27
Added to site: 2026-09-28
DOI: 10.1016/j.pnpbp.2026.111946

Electronic publication date verified in Europe PMC. This source date is separate from the site's addition date.

Modalities

rTMS, Diffusion MRI, Network analysis

Clinical focus

Depression, Response prediction, Personalization

Population

Patients with depression; detailed diagnostic and demographic criteria were not available in the checked abstract

Sample

204 patients receiving a four-week course of left-prefrontal rTMS

Intervention / method

Baseline diffusion MRI was used to quantify rich-club connection strength and modularity before four weeks of left-prefrontal rTMS

Comparator

Clinical outcomes were compared across network-feature groups; there was no sham or untreated control group

Clinician summary

Non-response and non-remission groups had lower baseline rich-club connection strength and modularity, all p < 0.05. The combined clinical-imaging model discriminated outcomes better than the clinical model alone, although the abstract does not report AUCs, thresholds or external validation.

How to interpret the findings

This observational cohort establishes association, not causal prediction. No sham group or independent validation cohort was reported, and the abstract omits numerical model performance, calibration, exact rTMS parameters, attrition and subgroup denominators. Imaging markers are not ready for individual clinical selection without replication and prospective validation.

Equipment and disclosures

Left-prefrontal rTMS and diffusion MRI were used; device, coil, targeting and dosing details were not available in the checked abstract.

The PubMed record reports no known competing financial interests or personal relationships. Funding details were not available in the checked index record.

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