More female patients and fewer stimuli per session are associated with the short-term antidepressant properties of repetitive transcranial magnetic stimulation (rTMS): a meta-analysis of 54 sham-controlled studies published between 1997-2013
Repetitive transcranial magnetic stimulation (rTMS) of the dorsolateral prefrontal cortex (DLPFC) appears to have short-term antidepressant properties. The aim of the current study was to update our previous meta-analysis and to investigate factors associated with the antidepressant properties of rT...
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| description | Repetitive transcranial magnetic stimulation (rTMS) of the dorsolateral prefrontal cortex (DLPFC) appears to have short-term antidepressant properties. The aim of the current study was to update our previous meta-analysis and to investigate factors associated with the antidepressant properties of rTMS.
Following a systematic literature search conducted in Medline and PsycInfo, N=14 sham-controlled, parallel design studies (published after 2008 to August 2013) that had utilized rTMS of the DLPFC in major depression were included in the current meta-analysis. The sensitivity and moderator analyses also included data from N=40 studies (published in 1997-2008) from our previous meta-analysis. The effect size (Cohen's d) in each study was the standardized difference in mean depression scores (on Hamilton Depression Rating Scale, Beck Depression Inventory, Montgomery Åsberg Depression Rating Scale) from baseline to final (after last session) in rTMS compared to sham groups.
According to a random-effects model with inverse-variance weights, depression scores were significantly reduced after rTMS compared to sham in studies published from 2008-2013 based on N=659 patients (overall mean weighted d=-0.42, 95% confidence interval: -0.66, -0.18, P=0.001). Combining studies from our past and current meta-analyses (published in 1997-2013; N=54) revealed that depression was significantly reduced after left-fast (>1 Hz), right-slow (≤1 Hz), and bilateral (or sequential) rTMS of DLPFC compared to sham. Significant antidepressant properties of rTMS were observed in studies with patients who were treatment resistant, unipolar (or bipolar), non-psychotic, medication-free (or started on antidepressants concurrently with rTMS). According to univariate meta-regressions, depression scores were significantly lower in studies with more female patients and fewer stimuli per session. There was little evidence that publication bias occurred in the analysis.
According to this study, the largest meta-analysis to date, short-term antidepressant properties of rTMS are independent of concurrent antidepressants and might depend on sex and the number of stimuli per session. |
| doi_str_mv | 10.2147/NDT.S58405 |
| format | Article |
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Following a systematic literature search conducted in Medline and PsycInfo, N=14 sham-controlled, parallel design studies (published after 2008 to August 2013) that had utilized rTMS of the DLPFC in major depression were included in the current meta-analysis. The sensitivity and moderator analyses also included data from N=40 studies (published in 1997-2008) from our previous meta-analysis. The effect size (Cohen's d) in each study was the standardized difference in mean depression scores (on Hamilton Depression Rating Scale, Beck Depression Inventory, Montgomery Åsberg Depression Rating Scale) from baseline to final (after last session) in rTMS compared to sham groups.
According to a random-effects model with inverse-variance weights, depression scores were significantly reduced after rTMS compared to sham in studies published from 2008-2013 based on N=659 patients (overall mean weighted d=-0.42, 95% confidence interval: -0.66, -0.18, P=0.001). Combining studies from our past and current meta-analyses (published in 1997-2013; N=54) revealed that depression was significantly reduced after left-fast (>1 Hz), right-slow (≤1 Hz), and bilateral (or sequential) rTMS of DLPFC compared to sham. Significant antidepressant properties of rTMS were observed in studies with patients who were treatment resistant, unipolar (or bipolar), non-psychotic, medication-free (or started on antidepressants concurrently with rTMS). According to univariate meta-regressions, depression scores were significantly lower in studies with more female patients and fewer stimuli per session. There was little evidence that publication bias occurred in the analysis.
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Following a systematic literature search conducted in Medline and PsycInfo, N=14 sham-controlled, parallel design studies (published after 2008 to August 2013) that had utilized rTMS of the DLPFC in major depression were included in the current meta-analysis. The sensitivity and moderator analyses also included data from N=40 studies (published in 1997-2008) from our previous meta-analysis. The effect size (Cohen's d) in each study was the standardized difference in mean depression scores (on Hamilton Depression Rating Scale, Beck Depression Inventory, Montgomery Åsberg Depression Rating Scale) from baseline to final (after last session) in rTMS compared to sham groups.
According to a random-effects model with inverse-variance weights, depression scores were significantly reduced after rTMS compared to sham in studies published from 2008-2013 based on N=659 patients (overall mean weighted d=-0.42, 95% confidence interval: -0.66, -0.18, P=0.001). Combining studies from our past and current meta-analyses (published in 1997-2013; N=54) revealed that depression was significantly reduced after left-fast (>1 Hz), right-slow (≤1 Hz), and bilateral (or sequential) rTMS of DLPFC compared to sham. Significant antidepressant properties of rTMS were observed in studies with patients who were treatment resistant, unipolar (or bipolar), non-psychotic, medication-free (or started on antidepressants concurrently with rTMS). According to univariate meta-regressions, depression scores were significantly lower in studies with more female patients and fewer stimuli per session. There was little evidence that publication bias occurred in the analysis.
According to this study, the largest meta-analysis to date, short-term antidepressant properties of rTMS are independent of concurrent antidepressants and might depend on sex and the number of stimuli per session.</description><subject>Antidepressants</subject><subject>Care and treatment</subject><subject>Demographic aspects</subject><subject>depression</subject><subject>Depression, Mental</subject><subject>DLPFC</subject><subject>Health aspects</subject><subject>Magnetic brain stimulation</subject><subject>Mental depression</subject><subject>Meta-analysis</subject><subject>Methods</subject><subject>Original Research</subject><subject>Patients</subject><subject>Prefrontal cortex</subject><subject>Psychiatry</subject><subject>Psychological aspects</subject><subject>Psychosis</subject><subject>repetitive transcranial magnetic stimulation (rTMS)</subject><subject>Sex differences (Psychology)</subject><subject>sham-controlled</subject><subject>Short term</subject><subject>Stimuli (Psychology)</subject><subject>Studies</subject><subject>Systematic review</subject><subject>Transcranial magnetic stimulation</subject><issn>1176-6328</issn><issn>1176-6328</issn><issn>1178-2021</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqNU81u1DAQjhCIlsKFB0CWkFBBSrEdJ044IFXlV2rh0L1bjjNpXDlxsJ1WfWzegFl2abuIA4qUjMbfz2TGk2XPGT3iTMi33z6sjs7LWtDyQbbPmKzyquD1w3vxXvYkxktKC9nU9eNsj4u6LIuK7mc_z3wA0sOoHZBZJwtTikRPHeauIZCY7Lg4S-Z1DDFaPxGNDB2jN1Yn6Mi1TQNJA5A4-JDyBGFEgWQ7mAMyMCRz8CiA4pH4ngSYIdlkr4CkoKdo8GW1I6O-mPDAbE2xGDQ7DKuz89fviCYjJJ3rSbubaH_rlAIt9ZgbP6XgncNaYlq6tcu8tM7GATMtpGuAibCmkTmnrHiaPeq1i_Bs-z3IVp8-rk6-5KffP389OT7NTcVFykXbVjXlQnDTF9g5Rsuir4zhpeBVJ1qgPUjeNryURtKupa3pmJayEVBWtSkOsvcbWSxlhM5gX4N2ag521OFGeW3V7slkB3Xhr5SgrKlYiQJ0I9D5q00nd8h3WeNHxSrJJFIOt57B_1ggJjXaaMA5PYFfokJVUYta1vV_QHldCEqbCqEv_4Je-iXgHKLiHCE15428Q13gTVJ26j3-lVmLqmPBWFEIyQtEHf0DhU8Ho8U5Qm8xv0N4dY8wgHZpiN4t67sRd4FvNkATfIwB-ttuMarWa6JwTdRmTRD84v5wbqF_9qL4BfjDEPk</recordid><startdate>20140101</startdate><enddate>20140101</enddate><creator>Kedzior, Karina Karolina</creator><creator>Azorina, Valeriya</creator><creator>Reitz, Sarah Kim</creator><general>Dove Medical Press Limited</general><general>Taylor & Francis Ltd</general><general>Dove Press</general><general>Dove Medical Press</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88G</scope><scope>8AO</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M2M</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>7TK</scope><scope>5PM</scope></search><sort><creationdate>20140101</creationdate><title>More female patients and fewer stimuli per session are associated with the short-term antidepressant properties of repetitive transcranial magnetic stimulation (rTMS): a meta-analysis of 54 sham-controlled studies published between 1997-2013</title><author>Kedzior, Karina Karolina ; Azorina, Valeriya ; Reitz, Sarah Kim</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c624t-4bb6802442cf30031053f6cc25426d4be0fe72b9257c70db0bcd1a7794e568c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Antidepressants</topic><topic>Care and treatment</topic><topic>Demographic aspects</topic><topic>depression</topic><topic>Depression, Mental</topic><topic>DLPFC</topic><topic>Health aspects</topic><topic>Magnetic brain stimulation</topic><topic>Mental depression</topic><topic>Meta-analysis</topic><topic>Methods</topic><topic>Original Research</topic><topic>Patients</topic><topic>Prefrontal cortex</topic><topic>Psychiatry</topic><topic>Psychological aspects</topic><topic>Psychosis</topic><topic>repetitive transcranial magnetic stimulation (rTMS)</topic><topic>Sex differences (Psychology)</topic><topic>sham-controlled</topic><topic>Short term</topic><topic>Stimuli (Psychology)</topic><topic>Studies</topic><topic>Systematic review</topic><topic>Transcranial magnetic stimulation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kedzior, Karina Karolina</creatorcontrib><creatorcontrib>Azorina, Valeriya</creatorcontrib><creatorcontrib>Reitz, Sarah Kim</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Psychology Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Psychology Database</collection><collection>Research Library</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>Neurosciences Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Neuropsychiatric disease and treatment</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kedzior, Karina Karolina</au><au>Azorina, Valeriya</au><au>Reitz, Sarah Kim</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>More female patients and fewer stimuli per session are associated with the short-term antidepressant properties of repetitive transcranial magnetic stimulation (rTMS): a meta-analysis of 54 sham-controlled studies published between 1997-2013</atitle><jtitle>Neuropsychiatric disease and treatment</jtitle><addtitle>Neuropsychiatr Dis Treat</addtitle><date>2014-01-01</date><risdate>2014</risdate><volume>10</volume><spage>727</spage><epage>756</epage><pages>727-756</pages><issn>1176-6328</issn><eissn>1176-6328</eissn><eissn>1178-2021</eissn><abstract>Repetitive transcranial magnetic stimulation (rTMS) of the dorsolateral prefrontal cortex (DLPFC) appears to have short-term antidepressant properties. The aim of the current study was to update our previous meta-analysis and to investigate factors associated with the antidepressant properties of rTMS.
Following a systematic literature search conducted in Medline and PsycInfo, N=14 sham-controlled, parallel design studies (published after 2008 to August 2013) that had utilized rTMS of the DLPFC in major depression were included in the current meta-analysis. The sensitivity and moderator analyses also included data from N=40 studies (published in 1997-2008) from our previous meta-analysis. The effect size (Cohen's d) in each study was the standardized difference in mean depression scores (on Hamilton Depression Rating Scale, Beck Depression Inventory, Montgomery Åsberg Depression Rating Scale) from baseline to final (after last session) in rTMS compared to sham groups.
According to a random-effects model with inverse-variance weights, depression scores were significantly reduced after rTMS compared to sham in studies published from 2008-2013 based on N=659 patients (overall mean weighted d=-0.42, 95% confidence interval: -0.66, -0.18, P=0.001). Combining studies from our past and current meta-analyses (published in 1997-2013; N=54) revealed that depression was significantly reduced after left-fast (>1 Hz), right-slow (≤1 Hz), and bilateral (or sequential) rTMS of DLPFC compared to sham. Significant antidepressant properties of rTMS were observed in studies with patients who were treatment resistant, unipolar (or bipolar), non-psychotic, medication-free (or started on antidepressants concurrently with rTMS). According to univariate meta-regressions, depression scores were significantly lower in studies with more female patients and fewer stimuli per session. There was little evidence that publication bias occurred in the analysis.
According to this study, the largest meta-analysis to date, short-term antidepressant properties of rTMS are independent of concurrent antidepressants and might depend on sex and the number of stimuli per session.</abstract><cop>New Zealand</cop><pub>Dove Medical Press Limited</pub><pmid>24855360</pmid><doi>10.2147/NDT.S58405</doi><tpages>30</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1176-6328 |
| ispartof | Neuropsychiatric disease and treatment, 2014-01, Vol.10, p.727-756 |
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| language | eng |
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| source | Taylor & Francis Open Access; DOVE Medical Press Journals; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
| subjects | Antidepressants Care and treatment Demographic aspects depression Depression, Mental DLPFC Health aspects Magnetic brain stimulation Mental depression Meta-analysis Methods Original Research Patients Prefrontal cortex Psychiatry Psychological aspects Psychosis repetitive transcranial magnetic stimulation (rTMS) Sex differences (Psychology) sham-controlled Short term Stimuli (Psychology) Studies Systematic review Transcranial magnetic stimulation |
| title | More female patients and fewer stimuli per session are associated with the short-term antidepressant properties of repetitive transcranial magnetic stimulation (rTMS): a meta-analysis of 54 sham-controlled studies published between 1997-2013 |
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