Effects of different transcranial magnetic stimulation modes on refractory depression in adults:a network meta-analysis
- VernacularTitle:经颅磁刺激不同模式干预成人难治性抑郁症的网状Meta分析
- Author:
Jinxin TIAN
1
;
Yuxin ZHAO
1
;
Tong HU
1
;
Tiantian CUI
1
;
Lihong MA
1
Author Information
- Publication Type:Journal Article
- Keywords: refractory depression; transcranial magnetic stimulation; high-frequency transcranial magnetic stimulation; low-frequency transcranial magnetic stimulation; bilateral sequential transcranial magnetic stimulation; intermittent theta burst stimulation; bilat
- From: Chinese Journal of Tissue Engineering Research 2025;29(35):7639-7648
- CountryChina
- Language:Chinese
- Abstract: OBJECTIVE:To assess the efficacy and safety of transcranial magnetic stimulation in the treatment of refractory depression and to compare the differences in efficacy between various transcranial magnetic stimulation treatment protocols in refractory depression,thereby providing a theoretical basis for the clinical selection of transcranial magnetic stimulation treatment protocols.METHODS:A comprehensive search was conducted across multiple databases,including PubMed,Embase,Cochrane Library,Web of Science,CNKI,WanFang Data,CBM and VIP.The search terms were"transcranial magnetic stimulation,treatment-resistant depression,randomized controlled trial"in Chinese,and"depressive disorder,treatment-resistant,transcranial magnetic stimulation,randomized controlled trial"in English.The objective was to identify randomized controlled trials on the treatment of patients with refractory depression published from the establishment of the databases to September 2024.The quality of the included studies was evaluated using the Cochrane risk of bias assessment tool,version 5.1.0,and the Physiotherapy Evidence Database scale.Meta-analysis of the outcome indicators was conducted using the Review Manager 5.4 and Stata 18.0 software.RESULTS:(1)Following a comprehensive review,20 randomized controlled trials were included in the analysis.All of the trials were assessed to be of high or very high quality according to the Physiotherapy Evidence Database scale.(2)Meta-analysis results showed that,compared with the sham stimulation group,high-frequency repetitive transcranial magnetic stimulation could significantly reduce the scores of Hamilton Depression Rating Scale[mean difference(MD)=-3.89,95％confidence interval(CI):-6.14 to-1.65,P＜0.05)or the Montgomery Depression Rating Scale(MD=-3.97,95％CI:-6.57 to-1.36,P＜0.05).(3)The probability ranking results of the network Meta-analysis showed that,in terms of the Hamilton Depression Rating Scale score,the probability ranking results were as follows:high-frequency repetitive transcranial magnetic stimulation(69.9％)＞intermittent theta burst stimulation(62.8％)＞bilateral theta pulse stimulation(57.5％)＞low-frequency repetitive transcranial magnetic stimulation(54.9％)＞bilateral sequential transcranial magnetic stimulation(49.0％)＞transcranial pulsed electromagnetic field(37.0％)＞sham stimulation(18.9％).And in terms of the Montgomery Depression Rating Scale score,the probability ranking results were as follows:high-frequency repetitive transcranial magnetic stimulation(93.3％)＞bilateral theta pulse stimulation(50.3％)＞sham stimulation(45.9％)＞low-frequency repetitive transcranial magnetic stimulation(32.1％)＞bilateral sequential transcranial magnetic stimulation(28.4％).CONCLUSION:Transcranial magnetic stimulations can improve the depressive symptoms of patients with treatment-resistant depression.Among them,the high-frequency repetitive transcranial magnetic stimulation mode has the best effect on improving the depressive symptoms of patients with treatment-resistant depression,followed by the intermittent θ burst stimulation mode.
