Deep transcranial magnetic stimulation for treatment-resistant obsessive-compulsive disorder: A meta-analysis of randomized-controlled trials

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research Pub Date : 2024-10-03 DOI:10.1016/j.jpsychires.2024.09.043

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引用次数: 0

Abstract

Background

Deep transcranial magnetic stimulation (dTMS), an advancement of transcranial magnetic stimulation, was created to reach wider and possibly more profound regions of the brain. At present, there is insufficient high-quality evidence to support the effectiveness and safety of dTMS in treating obsessive-compulsive disorder (OCD).

Objective

This study used a meta-analysis to evaluate the effectiveness and safety of dTMS for treating OCD.

Methods

Four randomized controlled trials were found by searching PubMed, Embase, Web of Science, and Cochrane Library up to February 2024. The fixed effects meta-analysis model was used for the purpose of data merging in Stata17. The risk ratio (RR) value was used as the measure of effect size to compare response rates and dropout rates between active and sham dTMS.

Results

The meta-analysis included four randomized-controlled trials involving 252 patients with treatment-resistant OCD. Active dTMS showed a notably greater rate of response on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) in comparison to sham dTMS after treatment (Y-BOCS: RR = 3.71, 95% confidence interval [CI] 2.06 to 6.69) and at the one-month follow-up (Y-BOCS: RR = 2.60, 95% CI 1.59 to 4.26). Subgroup analysis revealed that active dTMS with H-coils was more effective than sham dTMS (RR = 3.57, 95%CI 1.93 to 6.60). No serious adverse events were documented in the studies that were included.

Conclusion

The findings suggest that dTMS demonstrates notable efficacy and safety in treating patients with treatment-resistant OCD compared to sham dTMS, with sustained effectiveness noted throughout the one-month post-treatment period.

查看原文本刊更多论文

深部经颅磁刺激治疗难治性强迫症：随机对照试验的荟萃分析。

背景：深部经颅磁刺激（dTMS）是经颅磁刺激的一种新技术，其作用范围更广，可能更深入大脑的各个区域。目前，还没有足够的高质量证据支持经颅磁刺激治疗强迫症（OCD）的有效性和安全性：本研究采用荟萃分析法评估经颅磁刺激治疗强迫症的有效性和安全性：方法：通过检索PubMed、Embase、Web of Science和Cochrane Library，找到了截至2024年2月的四项随机对照试验。在Stata17中使用固定效应荟萃分析模型进行数据合并。采用风险比（RR）值作为效应大小的衡量标准，以比较活性和假性 dTMS 的反应率和辍学率：荟萃分析包括四项随机对照试验，涉及 252 名治疗耐受性强迫症患者。在治疗后（Y-BOCS：RR = 3.71，95% 置信区间 [CI] 2.06 至 6.69）和一个月的随访中（Y-BOCS：RR = 2.60，95% 置信区间 [CI] 1.59 至 4.26），活性 dTMS 在耶鲁-布朗强迫症量表（Y-BOCS）上的反应率明显高于假性 dTMS。分组分析显示，使用 H 线圈的主动 dTMS 比假 dTMS 更有效（RR = 3.57，95%CI 1.93 至 6.60）。在纳入的研究中未发现严重不良事件：研究结果表明，与假性经颅磁刺激相比，经颅磁刺激在治疗难治性强迫症患者方面具有显著的疗效和安全性，并且在治疗后的一个月内疗效持续。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of psychiatric research 医学-精神病学

CiteScore

7.30

自引率

2.10%

发文量

622

审稿时长

130 days

期刊介绍： Founded in 1961 to report on the latest work in psychiatry and cognate disciplines, the Journal of Psychiatric Research is dedicated to innovative and timely studies of four important areas of research: (1) clinical studies of all disciplines relating to psychiatric illness, as well as normal human behaviour, including biochemical, physiological, genetic, environmental, social, psychological and epidemiological factors; (2) basic studies pertaining to psychiatry in such fields as neuropsychopharmacology, neuroendocrinology, electrophysiology, genetics, experimental psychology and epidemiology; (3) the growing application of clinical laboratory techniques in psychiatry, including imagery and spectroscopy of the brain, molecular biology and computer sciences;