Efficacy and acceptability of non-invasive brain stimulation for the treatment of adult unipolar and bipolar depression: A systematic review and meta-analysis of randomised sham-controlled trials

NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS

卷:92

Review

Mutz, Julian^1,2  Edgcumbe, Daniel R.³  Brunoni, Andre R.^4,5,6  Fu, Cynthia H. Y.^3,7 

[1] Imperial Coll London, Fac Med, Sch Publ Hlth, Dept Epidemiol & Biostat, Norfolk Pl, London W2 1PG, England

[2] Kings Coll London, Inst Psychiat Psychol & Neurosci, Social Genet & Dev Psychiat Ctr, London, England

[3] Univ East London, Coll Appl Hlth & Communities, Sch Psychol, London, England

[4] Univ Sao Paulo, Serv Interdisciplinary Neuromodulat, Hosp Clin HCFMUSP, Fac Med,Lab Neurosci LIM 27, Sao Paulo, SP, Brazil

[5] Univ Sao Paulo, Dept Inst Psychiat, Hosp Clin HCFMUSP, Fac Med,Natl Inst Biomarkers Psychiat INBioN, Sao Paulo, SP, Brazil

[6] Ludwig Maximilians Univ Munchen, Dept Psychiat & Psychotherapy, Munich, Germany

[7] Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Psychol Med, Ctr Affect Disorders, London, England

关键词: Transcranial magnetic stimulation;    Theta burst stimulation;    Transcranial direct current stimulation;    Depression;    Meta-analysis;    Brain stimulation;    Systematic review;   

DOI  :  10.1016/j.neubiorev.2018.05.015

来源: Elsevier

【 摘 要 】

We examined the efficacy and acceptability of non-invasive brain stimulation in adult unipolar and bipolar depression. Randomised sham-controlled trials of transcranial direct current stimulation (tDCS), transcranial magnetic stimulation (TMS) and theta-burst stimulation (TBS), without co-initiation of another treatment, were included. We analysed effects on response, remission, all-cause discontinuation rates and continuous depression severity measures. Fifty-six studies met our criteria for inclusion (N = 3058, mean age = 44.96 years, 61.73% female). Response rates demonstrated efficacy of high-frequency rTMS over the left DLPFC (OR = 3.75, 95% CI [2.44; 5.75]), right-sided low-frequency rTMS (OR = 7.44, 95%CI [2.06; 26.83]) bilateral rTMS (OR = 3.68,95%CI [1.66; 8.13]), deep TMS (OR = 1.69, 95%CI [1.003; 2.85]), intermittent TBS (OR = 4.70, 95%CI [1.14; 19.38]) and tDCS (OR = 4.17, 95% CI [2.25; 7.74]); but not for continuous TBS, bilateral TBS or synchronised TMS. There were no differences in all-cause discontinuation rates. The strongest evidence was for high-frequency rTMS over the left DLPFC. Intermittent TBS provides an advance in terms of reduced treatment duration. tDCS is a potential treatment for non-treatment resistant depression. To date, there is not sufficient published data available to draw firm conclusions about the efficacy and acceptability of TBS and sTMS.

【 授权许可】

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