Universität zu Köln

Sigrist, Christine ORCID: 0000-0002-6718-3230, Voeckel, Jasper, MacMaster, Frank P., Farzan, Faranak, Croarkin, Paul E., Galletly, Cherrie, Kaess, Michael ORCID: 0000-0003-0031-7764, Bender, Stephan and Koenig, Julian ORCID: 0000-0003-1009-9625 (2022). Transcranial magnetic stimulation in the treatment of adolescent depression: a systematic review and meta-analysis of aggregated and individual-patient data from uncontrolled studies. Eur. Child Adolesc. Psych., 31 (10). S. 1501 - 1526. NEW YORK: SPRINGER. ISSN 1435-165X

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Abstract

Transcranial magnetic stimulation (TMS) is a non-invasive treatment for adolescent major depressive disorder (MDD). Existing evidence on the efficacy of TMS in adolescent MDD awaits quantitative synthesis. A systematic literature search was conducted, and data from eligible studies were synthesized using random-effects models. Treatment-covariate interactions were examined in exploratory analyses of individual-patient data (IPD). Systematic search of the literature yielded 1264 hits, of which 10 individual studies (2 randomized trials) were included for quantitative synthesis of mainly uncontrolled studies. Individual patient data (IPD) were available from five trials (all uncontrolled studies). Quantitative synthesis of aggregated data revealed a statistically significant negative overall standardized mean change (pooled SMCC = 2.04, 95% CI [1.46; 2.61], SE = 0.29, p < .001), as well as a significant overall treatment response rate (Transformed Proportion = 41.30%, 95% CI [31.03; 51.57], SE = 0.05; p < 0.001), considering data from baseline to post-treatment. Exploratory IPD analyses suggests TMS might be more effective in younger individuals and individuals with more severe depression, and efficacy might be enhanced with certain treatment modality settings, including higher number of TMS sessions, longer treatment durations, and unilateral and not bilateral stimulation. Existing studies exhibit methodological shortcomings, including small-study effects and lack of control group, blinding, and randomization-compromising the credibility of the present results. To date, two randomized controlled trials on TMS in adolescent depression have been published, and the only large-scale randomized trial suggests TMS is not more effective than sham stimulation. Future large-scale, randomized, and sham-controlled trials are warranted. Future trials should ensure appropriate selection of patients for TMS treatment and guide precision medicine approaches for stimulation protocols.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Sigrist, Christine UNSPECIFIED orcid.org/0000-0002-6718-3230 UNSPECIFIED Voeckel, Jasper UNSPECIFIED UNSPECIFIED UNSPECIFIED MacMaster, Frank P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Farzan, Faranak UNSPECIFIED UNSPECIFIED UNSPECIFIED Croarkin, Paul E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Galletly, Cherrie UNSPECIFIED UNSPECIFIED UNSPECIFIED Kaess, Michael UNSPECIFIED orcid.org/0000-0003-0031-7764 UNSPECIFIED Bender, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Koenig, Julian UNSPECIFIED orcid.org/0000-0003-1009-9625 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-691497
DOI:	10.1007/s00787-022-02021-7
Journal or Publication Title:	Eur. Child Adolesc. Psych.
Volume:	31
Number:	10
Page Range:	S. 1501 - 1526
Date:	2022
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1435-165X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TREATMENT-RESISTANT DEPRESSION; RANDOMIZED CONTROLLED-TRIALS; TREATING MAJOR DEPRESSION; THETA-BURST STIMULATION; DOUBLE-BLIND; LOW-FREQUENCY; COMPARATIVE EFFICACY; BASIC PRINCIPLES; FUNNEL PLOTS; OPEN-LABEL Multiple languages Psychology, Developmental; Pediatrics; Psychiatry Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/69149