Rigor Reviewed

Rigor-Reviewed Manuscript

Connectivity-guided intermittent theta burst versus repetitive transcranial magnetic stimulation for treatment-resistant depression: a randomized controlled trial.

Name: Αlpha¹ Rigor Record — Connectivity-guided intermittent theta burst versus repetitive transcranial magnetic stimulation for treatment-resistant depression: a randomized controlled trial.
Item: Connectivity-guided intermittent theta burst versus repetitive transcranial magnetic stimulation for treatment-resistant depression: a randomized controlled trial.
Rating: 39
Author: Αlpha¹

Morriss R, Briley PM, Webster L, Abdelghani M, Barber S, Bates P, Brookes C, Hall B, Ingram L, Kurkar M, Lankappa S, Liddle PF, McAllister-Williams RH, O'Neil-Kerr A, Pszczolkowski S, Suazo Di Paola A, Walters Y, Auer DP

Paper source

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Αlpha¹ Rigor Review — 1★ (Critical), 1 critical, 4 high issues for “Connectivity-guided intermittent theta burst versus repetitive transcranial magnetic stimulation for treatment-resistant depression: a randomized controlled trial.”

Links back to this Rigor Record.

Αlpha¹ Editorial

This rigor review was examined and confirmed by Αlpha¹ Editorial · August 16, 2026

Αlpha¹ Rigor Review

Rigor Reviewed

1 / 5

Critical — a demonstrable failure

Interventional Study

Critical

High-priority

How this rating was calculated▸

Started at 5★ — deductions

IntegrityIntegrity concern ×3−1.5★
ClaimsUnsupported major claim−1★
CitationsUnresolved reference−0.25★
LinksDead data/code link−0.25★

A demonstrable critical failure caps the rating at the minimum, regardless of the deductions above.

Model-reported confidence: highReviewer agreement: highEngine: 7.39.0Source: full text

Problems surfaced5 types

Numerical inconsistencies1

Values that contradict each other or are impossible for the stated sample: recomputed p-values and test statistics, GRIM/GRIMMER checks on summary numbers, percentages against their own counts, totals against their parts, and estimates against their own confidence intervals.

Internal contradictions in the reported numbersAssessed

Overstated conclusions2

Conclusions that reach past what the paper's own results support — including a significance claim that no longer holds when the statistic is recomputed, and efficacy resting on an unvalidated surrogate endpoint.

Conclusions not supported by the paper’s own evidenceAssessed
Conclusions only partially backed by the presented evidenceAssessed

Broken references and links2

References checked against Crossref, OpenAlex and Retraction Watch for retractions and resolvability, plus declared data and code links probed for whether they resolve to content matching the paper.

Dead data/code linksRecomputed
References not resolvable to a published paperRecomputed

This Αlpha¹ Rigor Review uses AI Rigor Reviewers trained on a curated corpus of high-fidelity and retracted papers, with expert supervision and curation. It can still make mistakes; verify each finding against the source before relying on it.

Critical findings

• Baseline effective connectivity from rAI to lDLPFC predicts clinical improvement.

This is a well-conducted and transparently reported randomized controlled trial. The methodology is rigorous, with appropriate blinding, power analysis, and statistical handling. Minor reporting gaps (randomization method detail, device model, dead code link) and a few copyedit typos do not undermine the overall integrity.

Both reviewers classified the study as interventional and agreed on all dimensions. The statistics verification covered only a subset of tests (10 recomputed consistently); threshold-only p-values and resampling-based p-values were not machine-verified. The citation check flagged one reference as not found in registry, which is a potential fabrication signal.

6 major claims checked against the paper's own evidence: 1 not fully backed by the presented evidence (unsupported or overstated), 1 only partially supported (evidence backs part of the claim; gaps or caveats remain).

Efficacy claim is anchored to an adequate endpoint and a meaningful effect.

Recomputed 10 tests: 10 consistent, 0 inconsistent; 8 recomputed directly from the reported test statistics, 2 via agent-written checks.

3 integrity concerns flagged (0 high).

Reporting

Eight Dimensions8 pass

The introduction cites multiple prior studies and meta-analyses on rTMS and iTBS for depression, acknowledges the lack of long-term follow-up data, and builds a rationale for personalized connectivity-guided targeting based on prior pilot work. The hypothesis follows logically from the cited evidence. Limitations of prior research (e.g., short follow-up, small samples) are explicitly addressed as motivation for the trial.

Sub-criteria

prior work citedADEQUATE

premise rationaleADEQUATE

limitations addressedADEQUATE

Per reviewer (2) — the votes behind the verdict

PASSReviewer 1· 90% conf

The paper establishes a clear scientific premise by citing prior research on TMS, iTBS, and connectivity-guided approaches, and provides a logical rationale for the study hypothesis.

Evidence

direct quote[Introduction, paragraph 1]

“A meta-analysis confirmed the effectiveness and safety of both rTMS and TBS for TRD”