Efficacy and safety of intermittent theta burst stimulation versus high-frequency repetitive transcranial magnetic stimulation for patients with treatment-resistant depression: a systematic review

Frontiers in Psychiatry

Psychiatry

Dong-Bin Cai¹  Xing-Bing Huang²  Xin-Hu Yang²  Jian-Xin Mai²  Qi-Man Liu²  Can-jin Deng²  Wei Zheng²  Zhen-Juan Qin³  Xian-Jun Lan³ 

[1]Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China

[2]The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China

[3]The Brain Hospital of Guangxi Zhuang Autonomous Region, Liuzhou, China

关键词: intermittent theta burst stimulation;    high-frequency rTMS;    treatment-resistant depression;    systematic review;    response;   

DOI  :  10.3389/fpsyt.2023.1244289

 received in 2023-06-22, accepted in 2023-07-17,  发布年份 2023

来源: Frontiers

【 摘 要 】

ObjectiveIntermittent theta-burst stimulation (iTBS), which is a form of repetitive transcranial magnetic stimulation (rTMS), can produce 600 pulses to the left dorsolateral prefrontal cortex (DLPFC) in a stimulation time of just over 3 min. The objective of this systematic review was to compare the safety and efficacy of iTBS and high-frequency (≥ 5 Hz) rTMS (HF-rTMS) for patients with treatment-resistant depression (TRD).MethodsRandomized controlled trials (RCTs) comparing the efficacy and safety of iTBS and HF-rTMS were identified by searching English and Chinese databases. The primary outcomes were study-defined response and remission.ResultsTwo RCTs (n = 474) investigating the efficacy and safety of adjunctive iTBS (n = 239) versus HF-rTMS (n = 235) for adult patients with TRD met the inclusion criteria. Among the two included studies (Jadad score = 5), all were classified as high quality. No group differences were found regarding the overall rates of response (iTBS group: 48.0% versus HF-rTMS group: 45.5%) and remission (iTBS group: 30.0% versus HF-rTMS group: 25.2%; all Ps > 0.05). The rates of discontinuation and adverse events such as headache were similar between the two groups (all Ps > 0.05).ConclusionThe antidepressant effects and safety of iTBS and HF-rTMS appeared to be similar for patients with TRD, although additional RCTs with rigorous methodology are needed.

【 授权许可】

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Copyright © 2023 Lan, Yang, Qin, Cai, Liu, Mai, Deng, Huang and Zheng.