A Systematic Review of the Safety and Tolerability of Theta Burst Stimulation in Children and Adolescents

Elmaghraby, Rana; Sun, Qi; Özger, Can; Shekunov, Julia; Romanowicz, Magdalena; Croarkin, Paul E.

doi:10.1111/ner.13455

Cited by 18 publications

(9 citation statements)

References 42 publications

(86 reference statements)

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“…The adverse events were primarily mild, tolerable and transient. The most common adverse events in our study were pain at the simulated site (28%) and headache/dizziness (7%), compatible with earlier TBS studies (Elmaghraby et al, 2022; Hong et al, 2015; Ni, Chen, et al, 2021).…”

Section: Discussionsupporting

confidence: 91%

“…Of comparable retention rates and side effect profiles with earlier rTMS (Ameis et al, 2020;Enticott et al, 2014;Sokhadze et al, 2018) and TBS studies (Elmaghraby et al, 2022;Ni et al, 2017;, our study demonstrated that the 8-week regular cTBS paradigm for children, adolescents, and young adults with ASD, like iTBS, is safe and tolerable (Elmaghraby et al, 2022). The retention rate in our study was 97% (29/30) in the Active group, which was consistent with previous TBS and rTMS studies (Ameis et al, 2020).…”

Section: Discussionsupporting

confidence: 90%

“…Side effects were checked for each cTBS session using open‐ended questions regarding physical discomfort and then close‐ended questions including the most common side effects of TBS, such as “pain at application site”, “headache/dizziness,” and “tinnitus” (Elmaghraby et al, 2022).…”

Section: Methodsmentioning

confidence: 99%

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A lack of efficacy of continuous theta burst stimulation over the left dorsolateral prefrontal cortex in autism: A double blind randomized sham‐controlled trial

Chen

Chao

et al. 2023

Autism Research

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Although previous open-label trials suggest the therapeutic potential of inhibitory repetitive transcranial magnetic stimulation (rTMS) over the dorsolateral prefrontal cortex (DLPFC) in autism spectrum disorder (ASD), methodological caveats exist. We conducted an 8-week randomized, double-blind shamcontrolled trial to investigate the efficacy of inhibitory continuous theta burst stimulation (cTBS, a variant of rTMS) over the left DLPFC in individuals with ASD. Sixty children, adolescents and young adults (aged 8-30 years) with ASD without co-occurring intellectual disabilities were randomized to a 16-session 8-week cTBS versus sham stimulation course, with a follow-up 4 weeks after the trial. The Active group was not superior to the Sham group in any clinical or neuropsychological metrics at Week 8 or Week 12. Time effects of 8-week cTBS on symptoms and executive function were remarkable in both Active and Sham groups, with comparable response rates and effect sizes of changes in symptoms/cognition between groups. Our results from a sufficiently powered sample do not endorse the superior efficacy of cTBS over the left DLPFC to the shamed stimulation for children, adolescents and adults with ASD. These findings suggest that earlier positive open-label trial findings may be generalized by generalized/placebo effects. This highlights the urgent need for more rTMS/TBS studies with rigorous trial designs in ASD.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 90%

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A lack of efficacy of continuous theta burst stimulation over the left dorsolateral prefrontal cortex in autism: A double blind randomized sham‐controlled trial

Chen

Chao

et al. 2023

Autism Research

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“…Similarly, one systematic review focusing on the safety of adjunctive TBS for the general population found that 5% of subjects reported mild adverse events [ 47 ]. Another systematic review including studies focusing on children and adolescent patients found that TBS interventions were associated with mild adverse events [ 48 ]. Similarly, other neurotherapeutic strategies such as tDCS and tACS (transcranial alternating current stimulation) were safe and effective in treating patients with schizophrenia.…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review of Intermittent Theta Burst Stimulation for Neurocognitive Dysfunction in Older Adults with Schizophrenia

Zhang

Yang

Shi

et al. 2023

JPM

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Objective: Neurocognitive dysfunction is thought to be one of the core clinical features of schizophrenia, and older adults with schizophrenia exhibited greater overall cognitive deficits than younger adults. The aim of this systematic review was to examine the neurocognitive effects of intermittent theta burst stimulation (iTBS) as an adjunctive treatment for older adults suffering from schizophrenia. Methods: Randomized double-blinded controlled trials (RCTs) investigating the neurocognitive effects of adjunctive active iTBS versus sham iTBS in older adults with schizophrenia were systematically identified by independent investigators searching Chinese and English databases. Results: Two double-blinded RCTs (n = 132) compared the neurocognitive effects of adjunctive active iTBS (n = 66) versus sham iTBS (n = 66) in patients that fulfilled the inclusion criteria of this systematic review and were analyzed. One RCT found significant superiority of active iTBS over sham iTBS in improving neurocognitive performance in older adults with schizophrenia. In the other RCT, the findings on the neurocognitive effects of iTBS as measured by three different measurement tools were inconsistent. The dropout rate was reported in the two RCTs, ranging from 3.8% (3/80) to 7.7% (4/52). Conclusion: There is preliminary evidence that adjunctive iTBS may have some beneficial effects in the treatment of neurocognitive function in older patients with schizophrenia. Future RCTs with larger sample sizes focusing on the neurocognitive effects of adjunctive iTBS in older adults with schizophrenia are warranted to verify these findings.

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“…A broader spectrum of the depression diagnosis and comorbidity profile enabled inferences that reflect real-world clinical practice [24]. Side-effects were largely self-limiting; in line with observations from previous studies [9,25]. Improvement in cognition could reflect the specific effects of TBS, improvement in depression, or even practice effects [26].…”

Section: Contents Lists Available At Sciencedirectmentioning

confidence: 56%

Theta burst stimulation in adolescent depression: An open-label evaluation of safety, tolerability, and efficacy

2021

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A Systematic Review of the Safety and Tolerability of Theta Burst Stimulation in Children and Adolescents

Cited by 18 publications

References 42 publications

A lack of efficacy of continuous theta burst stimulation over the left dorsolateral prefrontal cortex in autism: A double blind randomized sham‐controlled trial

A lack of efficacy of continuous theta burst stimulation over the left dorsolateral prefrontal cortex in autism: A double blind randomized sham‐controlled trial

A Systematic Review of Intermittent Theta Burst Stimulation for Neurocognitive Dysfunction in Older Adults with Schizophrenia

Theta burst stimulation in adolescent depression: An open-label evaluation of safety, tolerability, and efficacy

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