Repetitive transcranial magnetic stimulation had a small short-term effect for improving depression in comparison with sham, but follow-up studies did not show that the small effect will continue for longer periods.Don't show hotkey manager dialog when you Ctrl+Alt+Shift+Click a UI element that has no hotkey symbol associated with it.įixed position offset when inputting a Heightfield not positionned at the origin. Overall, the body of evidence favoured ECT for treatment of patients who are treatment-resistant. Risk ratios for remission and response were 1.44 (95% CI 0.64-3.23, P =. Trials of rTMS versus ECT showed a statistically and clinically significant difference between rTMS and ECT in favour of ECT (WMD 5.97, 95% CI 0.94-11.0, P =. Risk ratios for remission and response were 2.20 (95% CI 1.44-3.38, P =. This translates to a number needed to treat of 10. There was a 10% absolute difference between rTMS and sham in the rates of remission or response. This improvement was smaller than the pre-specified clinically important treatment effect. Trials of rTMS versus sham showed a statistically significant improvement in depression scores with rTMS (weighted mean difference 2.31, 95% CI 1.19-3.43 P <. Twenty-three RCTs compared rTMS with sham, and six RCTs compared rTMS with electroconvulsive therapy (ECT). A meta-regression was undertaken to examine the effect of specific rTMS technical parameters on the treatment effects.

We examined the possibility of publication bias by constructing funnel plots and by Begg's and Egger's tests. Remission and response to the treatment were secondary outcomes, and we calculated number needed to treat on the basis of these outcomes. The primary outcome was changes in depression scores measured by the Hamilton Rating Scale for Depression (HRSD), and we considered, a priori, the mean difference of 3.5 points to be a clinically important treatment effect. Meta-analyses were conducted to obtain summary estimates. Two independent reviewers evaluated the abstracts for inclusion, reviewed full texts of eligible studies, and abstracted data.

This analysis examined the antidepressant efficacy of rTMS in patients with treatment-resistant unipolar depression.Ī literature search was performed for RCTs published from January 1, 1994, to November 20, 2014. To date, several randomized controlled trials (RCTs) have shown the efficacy of repetitive transcranial magnetic stimulation (rTMS) in the treatment of major depression.

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