Has repetitive transcranial magnetic stimulation (rTMS) treatment for depression improved? A systematic review and meta-analysis comparing the recent vs. the earlier rTMS studies


Felipe Fregni, MD, PhD, Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave-KS 452, Boston, MA 02215, USA.
E-mail: ffregni@bidmc.harvard.edu


Objective:  To investigate whether the recent repetitive transcranial magnetic stimulation (rTMS) studies on depression using new parameters of stimulation have shown improved clinical results.

Method:  We performed a systematic review and a meta-analysis of the rTMS studies on depression published in the past 12 months comparing these results with an earlier meta-analysis that analyzed the results of the initial rTMS studies on depression.

Results:  Using our inclusion criteria, we selected the meta-analysis of Martin [Br J Psychiatry (2003) Vol. 182, 480–491] that included 13 studies (324 patients) and five studies for the recent meta-analysis (274 patients). The pooled effect size (standardized mean difference between pretreatment vs. post-treatment) from the random effects model was −0.76 (95% confidence interval, CI, −1.01 to −0.51). This result was significantly larger than that of the earlier meta-analysis (−0.35, 95% CI −0.66 to −0.04).

Conclusion:  Our findings suggest that recent rTMS clinical trials have shown larger antidepressant effects when compared with the earlier studies.