Has repetitive transcranial magnetic stimulation (rTMS) treatment for depression improved? A systematic review and meta-analysis comparing the recent vs. the earlier rTMS studies

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Abstract:

Gross M, Nakamura L, Pascual-Leone A, Fregni F. Has repetitive transcranial magnetic stimulation (rTMS) treatment for depression improved? A systematic review and meta-analysis comparing the recent vs. the earlier rTMS studies. Objective: 

To investigate whether the recent repetitive transcranial magnetic stimulation (rTMS) studies on depression using new parameters of stimulation have shown improved clinical results. Method: 

We performed a systematic review and a meta-analysis of the rTMS studies on depression published in the past 12 months comparing these results with an earlier meta-analysis that analyzed the results of the initial rTMS studies on depression. Results: 

Using our inclusion criteria, we selected the meta-analysis of Martin [Br J Psychiatry (2003) Vol. 182, 480–491] that included 13 studies (324 patients) and five studies for the recent meta-analysis (274 patients). The pooled effect size (standardized mean difference between pretreatment vs. post-treatment) from the random effects model was −0.76 (95% confidence interval, CI, −1.01 to −0.51). This result was significantly larger than that of the earlier meta-analysis (−0.35, 95% CI −0.66 to −0.04). Conclusion: 

Our findings suggest that recent rTMS clinical trials have shown larger antidepressant effects when compared with the earlier studies.

Keywords: antidepressive agents; depression; electric stimulation therapy; meta-analysis; transcranial magnetic stimulation

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1600-0447.2007.01049.x

Affiliations: 1: Department of Psychiatry, University of São Paulo, São Paulo, Brazil 2: Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

Publication date: September 1, 2007

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