Testing the effectiveness of combined attention modification training with right DLPFC theta-burst stimulation
2025 — Combined cTBS + AMT for anxiety
Finding
Active cTBS combined with AMT was not superior to sham cTBS + AMT for reducing self-reported anxiety. The combined active condition did show changes in attention toward positive stimuli and gaze toward happy facial expressions.
Constraint
Mechanism/proximal effects did not translate into superior symptom reduction attributable to active cTBS in this feasibility study.
Why it matters
This should be a prominent stopping-point node in the cascade. It prevents the atlas from presenting neurostimulation as uniformly additive to cognitive intervention.
Full-text audit — v0.3.2
The study explicitly framed the active cTBS + AMT versus sham cTBS + AMT comparison as a test of the added benefit of cTBS. The anxiety endpoint did not support that added benefit. The only statistically significant treatment-specific pre/post reduction was in the sham-cTBS + active-AMT condition (d = 1.15). Active cTBS + AMT and active cTBS + control AMT showed moderate but non-significant pre/post effect sizes (d = 0.42 and d = 0.41, respectively).
The combined active condition did, however, show several proximal attention/gaze changes. This node therefore has two distinct outgoing relationships: a supported proximal-mechanism edge and a constrained symptom-efficacy edge.
