The association of total pulses with the efficacy of repetitive transcranial magnetic stimulation for treatment-resistant major depression : A dose-response meta-analysis
Copyright © 2024 Elsevier B.V. All rights reserved..
AIM: This study aimed to examine dose-effects of total pulses on improvement of depressive symptoms in patients with treatment-resistant depression (TRD) receiving repetitive transcranial magnetic stimulation (rTMS) over the left dorsal lateral prefrontal cortex (DLPFC).
MATERIALS AND METHODS: The MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, PsycINFO, and ClinicalTrial.gov databases were systematically searched. We included randomized, double-blind, placebo-controlled trials (RCT) that used rTMS over left DLPFC in patients with TRD. Excluded studies were non-TRD, non-RCTs, or combined other brain stimulation interventions. The outcome of interest was the difference between rTMS arms and sham controls in improvement of depressive symptoms in a dose-response manner. A random-effects meta-analysis and dose-response meta-analysis(DRMA) was used to examine antidepressant efficacy of rTMS and association with total pulses.
RESULTS: We found that rTMS over left DLPFC is superior to sham controls (reported as standardized mean difference[SMD] with 95% confidence interval: 0.77; 0.56-0.98). The best-fitting model of DRMA was bell-shaped (estimated using restricted cubic spline model; R2 =0.42), indicating that higher doses (>26,660 total pulses) were not associated with increased improvement of depressive symptoms. Stimulation frequency(R2 =0.53) and age(R2 =0.51) were significant moderators for the dose-response curve. Furthermore, 15-20 Hz rTMS was superior to 10 Hz rTMS (0.61, 0.15-1.10) when combining all doses.
CONCLUSIONS: Our findings suggest higher doses(total pulses) of rTMS were not always associated with increased improvement of depressive symptoms in patients with TRD, and that the dose-response relationship was moderated by stimulation frequency and age. These associations emphasize the importance of determining dosing parameters to achieve maximum efficacy.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:92 |
|---|---|
| Enthalten in: |
Asian journal of psychiatry - 92(2024) vom: 09. Feb., Seite 103891 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Yu, Chia-Ling [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 14.02.2024 Date Revised 14.02.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.ajp.2023.103891 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM366743570 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM366743570 | ||
| 003 | DE-627 | ||
| 005 | 20240214233053.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240108s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.ajp.2023.103891 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1293.xml |
| 035 | |a (DE-627)NLM366743570 | ||
| 035 | |a (NLM)38183740 | ||
| 035 | |a (PII)S1876-2018(23)00448-3 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Yu, Chia-Ling |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The association of total pulses with the efficacy of repetitive transcranial magnetic stimulation for treatment-resistant major depression |b A dose-response meta-analysis |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 14.02.2024 | ||
| 500 | |a Date Revised 14.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2024 Elsevier B.V. All rights reserved. | ||
| 520 | |a AIM: This study aimed to examine dose-effects of total pulses on improvement of depressive symptoms in patients with treatment-resistant depression (TRD) receiving repetitive transcranial magnetic stimulation (rTMS) over the left dorsal lateral prefrontal cortex (DLPFC) | ||
| 520 | |a MATERIALS AND METHODS: The MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, PsycINFO, and ClinicalTrial.gov databases were systematically searched. We included randomized, double-blind, placebo-controlled trials (RCT) that used rTMS over left DLPFC in patients with TRD. Excluded studies were non-TRD, non-RCTs, or combined other brain stimulation interventions. The outcome of interest was the difference between rTMS arms and sham controls in improvement of depressive symptoms in a dose-response manner. A random-effects meta-analysis and dose-response meta-analysis(DRMA) was used to examine antidepressant efficacy of rTMS and association with total pulses | ||
| 520 | |a RESULTS: We found that rTMS over left DLPFC is superior to sham controls (reported as standardized mean difference[SMD] with 95% confidence interval: 0.77; 0.56-0.98). The best-fitting model of DRMA was bell-shaped (estimated using restricted cubic spline model; R2 =0.42), indicating that higher doses (>26,660 total pulses) were not associated with increased improvement of depressive symptoms. Stimulation frequency(R2 =0.53) and age(R2 =0.51) were significant moderators for the dose-response curve. Furthermore, 15-20 Hz rTMS was superior to 10 Hz rTMS (0.61, 0.15-1.10) when combining all doses | ||
| 520 | |a CONCLUSIONS: Our findings suggest higher doses(total pulses) of rTMS were not always associated with increased improvement of depressive symptoms in patients with TRD, and that the dose-response relationship was moderated by stimulation frequency and age. These associations emphasize the importance of determining dosing parameters to achieve maximum efficacy | ||
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Dose-response meta-analysis | |
| 650 | 4 | |a High-frequency repetitive transcranial magnetic stimulation | |
| 650 | 4 | |a Stimulation frequency | |
| 650 | 4 | |a Total pulses | |
| 650 | 4 | |a Treatment-resistant depression | |
| 650 | 7 | |a Antidepressive Agents |2 NLM | |
| 700 | 1 | |a Kao, Yu-Chen |e verfasserin |4 aut | |
| 700 | 1 | |a Thompson, Trevor |e verfasserin |4 aut | |
| 700 | 1 | |a Brunoni, Andre R |e verfasserin |4 aut | |
| 700 | 1 | |a Hsu, Chih-Wei |e verfasserin |4 aut | |
| 700 | 1 | |a Carvalho, Andre F |e verfasserin |4 aut | |
| 700 | 1 | |a Chu, Che-Sheng |e verfasserin |4 aut | |
| 700 | 1 | |a Tseng, Ping-Tao |e verfasserin |4 aut | |
| 700 | 1 | |a Tu, Yu-Kang |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Fu-Chi |e verfasserin |4 aut | |
| 700 | 1 | |a Su, Kuan-Pin |e verfasserin |4 aut | |
| 700 | 1 | |a Cheng, Shu-Li |e verfasserin |4 aut | |
| 700 | 1 | |a Hsu, Tien-Wei |e verfasserin |4 aut | |
| 700 | 1 | |a Liang, Chih-Sung |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Asian journal of psychiatry |d 2008 |g 92(2024) vom: 09. Feb., Seite 103891 |w (DE-627)NLM193264730 |x 1876-2026 |7 nnns |
| 773 | 1 | 8 | |g volume:92 |g year:2024 |g day:09 |g month:02 |g pages:103891 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.ajp.2023.103891 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 92 |j 2024 |b 09 |c 02 |h 103891 | ||