{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T08:04:57Z","timestamp":1789632297685,"version":"build-2803163510"},"reference-count":0,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"unspecified","delay-in-days":132,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CNS Spectr."],"published-print":{"date-parts":[[2026]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Cognitive dysfunction is a core feature of major depressive disorder. During transcranial magnetic stimulation (TMS) for treatment-resistant depression (TRD), the temporal relationship between symptom changes and cognitive performance remains unclear. We examined depressive symptoms and cognitive trajectories during TMS and tested whether time-varying cognitive change was associated with symptom trajectories.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This retrospective naturalistic study included 89 patients with TRD who completed 20 sessions of left dorsolateral prefrontal cortex TMS (high-frequency repetitive TMS or intermittent theta-burst stimulation). Depression severity (Hamilton Depression Rating Scale [HAMD-17]) and computerized attentional control measures from the Test of Attentional Performance were assessed at baseline, day 10, and day 20. Generalized estimating equations examined time effects and time-adjusted symptom-cognition associations. Exploratory analyses evaluated whether early cognitive change was associated with subsequent symptom improvement. Multiple comparisons were controlled.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Depressive symptoms decreased significantly (p < 0.001), with response and remission rates of 65.2% and 51.7%. Several attentional indices showed significant time effects; however, after false discovery rate correction, only visual divided-attention commission errors were independently associated with depressive severity beyond time effects. Person-mean centering indicated that this association was driven by within-person change (B = 0.209, p < 0.001), not between-person differences. Greater early reduction in visual divided-attention commission errors was associated with larger overall symptom improvement (B = 0.172, p = 0.016).<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Within-person changes in divided attention tracked depressive symptom trajectories during TMS. Attentional control measures may therefore help track symptom-cognition dynamics during TMS in real-world clinical settings.<\/jats:p>\n <\/jats:sec>","DOI":"10.1017\/s1092852926100935","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T07:38:07Z","timestamp":1778657887000},"source":"Crossref","is-referenced-by-count":0,"title":["Longitudinal coupling between depressive symptoms and divided attention during transcranial magnetic stimulation in treatment-resistant depression"],"prefix":"10.1017","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7970-3758","authenticated-orcid":false,"given":"Mao-Hsuan","family":"Huang","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/014f77s28","id-type":"ROR","asserted-by":"publisher"}],"name":"General Cheng Hsin Hospital"},{"id":[{"id":"https:\/\/ror.org\/059ryjv25","id-type":"ROR","asserted-by":"publisher"}],"name":"School of Medicine, College of Medicine, National Yang Ming Chiao Tung University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yee-Lam E.","family":"Chan","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/014f77s28","id-type":"ROR","asserted-by":"publisher"}],"name":"General Cheng Hsin Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun-Ding","family":"Zhu","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/059ryjv25","id-type":"ROR","asserted-by":"publisher"}],"name":"College of Medical Science and Technology, Chung Shan Medical University"},{"name":"Chung Shan Medical University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Chung","family":"Mao","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/014f77s28","id-type":"ROR","asserted-by":"publisher"}],"name":"General Cheng Hsin Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Yuan","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/014f77s28","id-type":"ROR","asserted-by":"publisher"}],"name":"General Cheng Hsin Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yia-Ping","family":"Liu","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/014f77s28","id-type":"ROR","asserted-by":"publisher"}],"name":"General Cheng Hsin Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Chi","family":"Chen","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/014f77s28","id-type":"ROR","asserted-by":"publisher"}],"name":"General Cheng Hsin Hospital"},{"id":[{"id":"https:\/\/ror.org\/059ryjv25","id-type":"ROR","asserted-by":"publisher"}],"name":"School of Medicine, College of Medicine, National Yang Ming Chiao Tung University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng-Chang","family":"Yen","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/014f77s28","id-type":"ROR","asserted-by":"publisher"}],"name":"General Cheng Hsin Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Shen","family":"Huang","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/014f77s28","id-type":"ROR","asserted-by":"publisher"}],"name":"General Cheng Hsin Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tung-Ping","family":"Su","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/014f77s28","id-type":"ROR","asserted-by":"publisher"}],"name":"General Cheng Hsin Hospital"},{"id":[{"id":"https:\/\/ror.org\/059ryjv25","id-type":"ROR","asserted-by":"publisher"}],"name":"School of Medicine, College of Medicine, National Yang Ming Chiao Tung University"},{"name":"Institute of Brain Science, National Yang Ming Chao Tung University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,5,13]]},"container-title":["CNS Spectrums"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1092852926100935","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T07:29:36Z","timestamp":1789630176000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1092852926100935\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026]]}},"alternative-id":["S1092852926100935"],"URL":"https:\/\/doi.org\/10.1017\/s1092852926100935","relation":{},"ISSN":["1092-8529","2165-6509"],"issn-type":[{"value":"1092-8529","type":"print"},{"value":"2165-6509","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"e34"}}