Efficacy and tolerability of theta-burst stimulation for major depression: A systematic review and meta-analysis

Hsuan Te Chu, Chih Ming Cheng, Chih Sung Liang, Wen Han Chang, Chi Hung Juan, Ying Zu Huang, Jia Shyun Jeng, Ya Mei Bai, Shih Jen Tsai, Mu Hong Chen, Cheng Ta Li

Research output: Contribution to journalReview articlepeer-review

7 Scopus citations

Abstract

Background: Repetitive transcranial magnetic stimulation (rTMS) is the current treatment option for major depression (MD). Theta-burst stimulation (TBS), a variation of rTMS, affords a short stimulation duration, low stimulation pulse intensity, and possibility to improve rTMS efficiency. This systematic review and meta-analysis examined the studies on efficacy and tolerability of TBS in patients with MD. Methods: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched the literature from 1990 until May 24, 2020, and performed a random-effects meta-analysis by including response and remission rates of depression and dropout rates as main outcome measures. Results: In total, 10 studies including 6 randomized controlled trials (RCTs; n = 294) and 4 uncontrolled clinical trials (non-RCTs; n = 297) were included. The overall effect size of response rate and remission rates were 0.38 (95% confidence interval [CI]: 0.29–0.48) and 0.20 (95% CI: 0.13–0.29), respectively. Notably, the TBS group showed favorable efficacy without major adverse events. Conclusions: TBS treatment was more efficient in terms of time and energy than the standard rTMS was. Our meta-analysis provided evidence that the application of TBS to the dorsolateral prefrontal cortex is associated with significant antidepressant effects along with favorable tolerability.

Original languageEnglish
Article number110168
JournalProgress in Neuro-Psychopharmacology and Biological Psychiatry
Volume106
DOIs
StatePublished - 2 Mar 2021

Keywords

  • Efficacy
  • Major depression
  • Meta-analysis
  • Theta-burst stimulation
  • Tolerability

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