Abstract
Background: High-frequency (HF) repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (L-DLPFC) is the most widely applied treatment protocol for major depressive disorder (MDD), while low-frequency (LF) rTMS over the right DLPFC (R-DLPFC) also exhibits similar, if not better, efficacy for MDD. Therefore, a meta-analysis is warranted to compare the efficacy of the two protocols for MDD.Method: We searched the literature from 1990 through to August 1, 2017 using MEDLINE, and the literature from 1995 through to August 1, 2017 using EMBASE, PsycINFO, the Cochrane Central Register of Controlled Trials (CENTRAL), SCOPUS, and ProQuest Dissertations and Theses (PQDT). We included randomized controlled trials (RCT) comparing the efficacy of HF rTMS over the L-DLPFC and LF rTMS over the R-DLPFC for MDD, which used response and/or remission rates as the primary endpoints, with and without sham-controlled.Results: (1) The meta-analysis of the response rates was based on 12 studies, including 361 patients with MDD (175 for HF (> 5 Hz) over the L-DLPFC, and 186 for LF (<5 Hz) over the R-DLPFC; odds ratio = 1.08; 95%, confidence interval = 0.88–1.34). (2) The meta-analysis of the remission rate was based on 5 studies, including 131 MDD patients (64 for HF over the L-DLPFC and 67 for LF over the R-DLPFC; odds ratio = 1.29; 95% confidence interval = 0.54–3.10).Conclusion: Both HF rTMS over the L-DLPFC and LF over the R-DLPFC demonstrated similar therapeutic efficacy for the treatment of patients with MDD. The results suggested that further investigation on treatment efficacy indicators before/during treatment is necessary and helpful for optimizing a personalized protocol for patients.
Highlights
Transcranial magnetic stimulation (TMS) is a non-intrusive neuromodulation technique used to induce brief magnetic pulses of up to several Tesla in strength, via rapid discharging current of several thousand amperes through a stimulation coil [1, 2]
A meta-analysis based on 29 randomized, double-blind, sham-controlled trials (RCTs), and 1,371 subjects with major depressive disorder (MDD) showed that HFrTMS was significantly effective in improving clinical scores compared to sham stimulation [11], and another meta-analysis consisting of eight RCTs and 263 subjects with MDD showed similar therapeutic efficacy of LF-repetitive transcranial magnetic stimulation (rTMS) for patients with MDD compared to sham stimulation [12]
The pooled OR was 1.08, indicating a comparative therapeutic efficacy between the two rTMS treatment protocols
Summary
Transcranial magnetic stimulation (TMS) is a non-intrusive neuromodulation technique used to induce brief magnetic pulses of up to several Tesla in strength, via rapid discharging current of several thousand amperes through a stimulation coil [1, 2]. A meta-analysis based on 29 randomized, double-blind, sham-controlled trials (RCTs), and 1,371 subjects with MDD showed that HFrTMS was significantly effective in improving clinical scores compared to sham stimulation [11], and another meta-analysis consisting of eight RCTs and 263 subjects with MDD showed similar therapeutic efficacy of LF-rTMS for patients with MDD compared to sham stimulation [12]. It is not clear which protocol is more effective or if they are equivalent for the treatment of MDD. A meta-analysis is warranted to compare the efficacy of the two protocols for MDD
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
