Antidepressant efficacy of high-frequency transcranial magnetic stimulation over the left dorsolateral prefrontal cortex in double-blind sham-controlled designs: a meta-analysis

Schutter, Dennis J.L.G.

doi:10.1017/s0033291708003462

Cited by 317 publications

(207 citation statements)

References 76 publications

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“…We identified articles for inclusion in this meta-analysis by ' Screening the bibliography of the previous meta-analyses on rTMS for MD (Allan et al, 2011;Burt et al, 2002;Couturier, 2005;Gross et al, 2007;Herrmann and Ebmeier, 2006;Kozel and George, 2002;Lam et al, 2008;Martin et al, 2002;Martin et al, 2003;McNamara et al, 2001;Schutter, 2009;Slotema et al, 2010), of the only meta-analysis on LF-rTMS for MD published to date (Schutter, 2010) The search procedures (including syntaxes, parameters, and results) are described in detail in the Supplementary Material.…”

Section: Methodology Of the Literature Review Search Strategymentioning

confidence: 99%

Clinically Meaningful Efficacy and Acceptability of Low-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) for Treating Primary Major Depression: A Meta-Analysis of Randomized, Double-Blind and Sham-Controlled Trials

Berlim

Eynde

Daskalakis

2012

Neuropsychopharmacol

244

140

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Clinical trials on low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) over the right dorsolateral prefrontal cortex have yielded conflicting evidence concerning its overall efficacy for treating major depression (MD). As this may have been the result of limited statistical power of individual trials, we have carried the present systematic review and meta-analysis to examine this issue. We searched the literature for English language randomized, double-blind and sham-controlled trials (RCTs) on LF-rTMS for treating MD from 1995 through July 2012 using EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials, SCOPUS, and ProQuest Dissertations & Theses, and from October 2008 until July 2012 using MEDLINE. The main outcome measures were response and remission rates as well as overall dropout rates at study end. We used a random-effects model, odds ratios (ORs) and number needed to treat (NNT). Data were obtained from eight RCTs, totaling 263 subjects with MD. After an average of 12.6±3.9 rTMS sessions, 38.2% (50/131) and 15.1% (20/132) of subjects receiving active LF-rTMS and sham rTMS were classified as responders (OR ¼ 3.35; 95% CI ¼ 1.4-8.02; p ¼ 0.007). Also, 34.6% (35/101) and 9.7% (10/103) of subjects receiving active LF-rTMS and sham rTMS were classified as remitters (OR ¼ 4.76; 95% CI ¼ 2.13-10.64; po0.0001). The associated NNT for both response and remission rates was 5. Sensitivity analyses have shown that protocols delivering 41200 magnetic pulses in total as well as those offering rTMS as a monotherapy for MD were associated with higher rates of response to treatment. No differences on mean baseline depression scores and dropout rates for active and sham rTMS groups were found. Finally, the risk of publication bias was low. In conclusion, LF-rTMS is a promising treatment for MD, as it provides clinically meaningful benefits that are comparable to those of standard antidepressants and high-frequency rTMS. Furthermore, LF-rTMS seems to be an acceptable intervention for depressed subjects.

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Section: Methodology Of the Literature Review Search Strategymentioning

confidence: 99%

Clinically Meaningful Efficacy and Acceptability of Low-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) for Treating Primary Major Depression: A Meta-Analysis of Randomized, Double-Blind and Sham-Controlled Trials

Berlim

Eynde

Daskalakis

2012

Neuropsychopharmacol

244

140

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“…A meta-analysis of 34 studies comparing rTMS to sham treatment showed a moderate effect size of 0.55 on depressive symptoms (Slotema, Blom, Hoek, & Sommer, 2010), whereas another meta-analysis of 30 HF-rTMS studies found an effect size of 0.39 (Schutter, 2009). …”

Section: Neurostimulation Approaches To Treatment Resistancementioning

confidence: 99%

Neurostimulation as an intervention for treatment resistant depression: From research on mechanisms towards targeted neurocognitive strategies

Raedt

Vanderhasselt

Baeken

2015

Clinical Psychology Review

102

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Despite the fact that several interventions for major depression have proven efficacy, a substantial number of patients are or become treatment resistant to various forms of pharmacotherapy and psychotherapy. Biological interventions that directly target brain activity such as electroconvulsive therapy are used to treat these patients, but some of these interventions are unlikely to be easily accepted because of their more invasive nature or sideeffects. The efficacy of non-invasive neurostimulation with a favorable side effect profile, such as repetitive Transcranial Magnetic Stimulation, could not be sufficiently demonstrated for treatment resistant depressed patients (TRD). We argue that research on the working mechanisms of these neurostimulation techniques is necessary to develop more efficient treatment protocols. After an overview of current neurostimulation approaches to treatment resistance and the introduction of a neurobiological and a cognitive framework of depression, we provide an integrative review of research on both the neurobiological and cognitive working mechanisms of neurostimulation in TRD, with a specific emphasis on the work of our lab. Thereafter, we describe our own studies and studies from other labs on new neurocognitive interventions. Finally we discuss how all this knowledge can be used to further develop new strategies to deal with treatment resistance, in combining neurostimulation and cognitive interventions.

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“…However, they concluded that the clinical benefits are marginal in the majority of reports and there is still considerable uncertainty concerning the "Online" approach: concurrent TMS and neuroimaging "Offline" approach: neuroimaging before TMS "Offline" approach: TMS before neuroimaging optimal stimulation parameters. Two recent positive metaanalyses suggest that the overall effect size with TMS in major depression is at least as good as that of standard pharmacotherapy (Lam et al, 2008;Schutter, 2008). Those clinical features that appear to be associated with greater response include younger age, lack of refractoriness to antidepressants, and no psychotic features (Avery et al, 2008).…”

Section: Clinical Studiesmentioning

confidence: 99%

Noninvasive techniques for probing neurocircuitry and treating illness: vagus nerve stimulation (VNS), transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS)

George

Aston‐Jones

2009

Neuropsychopharmacol

312

188

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Although the preceding chapters discuss much of the new knowledge of neurocircuitry of neuropsychiatric diseases, and an invasive approach to treatment, this chapter describes and reviews the noninvasive methods of testing circuit-based theories and treating neuropsychiatric diseases that do not involve implanting electrodes into the brain or on its surface. These techniques are transcranial magnetic stimulation, vagus nerve stimulation, and transcranial direct current stimulation. Two of these approaches have FDA approval as therapies.

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Antidepressant efficacy of high-frequency transcranial magnetic stimulation over the left dorsolateral prefrontal cortex in double-blind sham-controlled designs: a meta-analysis

Abstract: These findings show that high-frequency rTMS over the left DLPFC is superior to sham in the treatment of depression. The effect size is robust and comparable to at least a subset of commercially available antidepressant drug agents. Current limitations and future prospects are discussed.

Cited by 317 publications

References 76 publications

Clinically Meaningful Efficacy and Acceptability of Low-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) for Treating Primary Major Depression: A Meta-Analysis of Randomized, Double-Blind and Sham-Controlled Trials

Clinically Meaningful Efficacy and Acceptability of Low-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) for Treating Primary Major Depression: A Meta-Analysis of Randomized, Double-Blind and Sham-Controlled Trials

Neurostimulation as an intervention for treatment resistant depression: From research on mechanisms towards targeted neurocognitive strategies

Noninvasive techniques for probing neurocircuitry and treating illness: vagus nerve stimulation (VNS), transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS)

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