Is Theta Burst Stimulation Ready as a Clinical Treatment for Bipolar Disorder?

IF 5 2区医学 Q1 CLINICAL NEUROLOGY

Bipolar Disorders Pub Date : 2025-04-15 DOI:10.1111/bdi.70025

Yufei Wu, Danni Yan, Jianli Yang

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引用次数: 0

Abstract

Background: To date, no studies have investigated the efficacy of theta burst stimulation (TBS) in the treatment of bipolar disorder (BD), and the results are inconclusive.

Objective: We aim to systematically review the existing literature related to the efficacy of TBS in BD and synthesize the results through meta-analysis.

Methods: We searched for PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of science, PsycINFO, CNKI, and Wan fang databases without language restriction through July 30, 2023, and included randomized-controlled trials that assessed the treatment effect of TBS in patients with BD. We used a random-effects model to pool effect sizes, which were expressed as Cohen's d (or Odds ratio) and 95% confidence intervals (CIs). The outcome measures include changes in Montgomery-Asberg Depression Rating Scale (MADRS) scores, response and remission rates of depression, and dropout rates.

Result: Eight randomized sham-controlled trials were included in the meta-analysis. The overall effect size of the outcome measures, including changes in MARDS scale scores, response rate, and remission rates, were -0.81 (95% confidence interval [CI]: 4.07 to 2.44), 1.07 (95% CI: 0.47 to 2.44) and 0.74 (95% CI: 0.38 to 1.45), respectively. Notably, the TBS group showed favorable efficacy without major adverse events.

Conclusion: Current studies indicate that TBS does not show significant antidepressant efficacy in patients with BD, although it is very well tolerated.

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θ波爆发刺激是否可以作为双相情感障碍的临床治疗方法？

背景：到目前为止，还没有研究调查了θ波爆发刺激（TBS）治疗双相情感障碍（BD）的疗效，结果也不确定。目的：系统回顾现有TBS治疗BD的相关文献，并通过meta分析对结果进行综合。方法：检索截至2023年7月30日的PubMed、Embase、Cochrane Central Register of Controlled Trials、Web of science、PsycINFO、CNKI和万方无语言限制的数据库，纳入评估TBS对BD患者治疗效果的随机对照试验。我们使用随机效应模型汇集效应大小，用Cohen’s d （or Odds ratio）和95%置信区间（ci）表示。结果测量包括蒙哥马利-阿斯伯格抑郁评定量表（MADRS）得分的变化、抑郁症的反应率和缓解率以及辍学率。结果：meta分析纳入8个随机假对照试验。结果测量的总体效应大小，包括MARDS量表得分、反应率和缓解率的变化，分别为-0.81（95%可信区间[CI]: 4.07至2.44）、1.07 （95% CI: 0.47至2.44）和0.74 （95% CI: 0.38至1.45）。值得注意的是，TBS组疗效良好，无重大不良事件。结论：目前的研究表明，TBS对BD患者的抗抑郁疗效不显著，但耐受性很好。

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

Bipolar Disorders 医学-精神病学

CiteScore

8.20

自引率

7.40%

发文量

审稿时长

6-12 weeks

期刊介绍： Bipolar Disorders is an international journal that publishes all research of relevance for the basic mechanisms, clinical aspects, or treatment of bipolar disorders and related illnesses. It intends to provide a single international outlet for new research in this area and covers research in the following areas: biochemistry physiology neuropsychopharmacology neuroanatomy neuropathology genetics brain imaging epidemiology phenomenology clinical aspects and therapeutics of bipolar disorders Bipolar Disorders also contains papers that form the development of new therapeutic strategies for these disorders as well as papers on the topics of schizoaffective disorders, and depressive disorders as these can be cyclic disorders with areas of overlap with bipolar disorders. The journal will consider for publication submissions within the domain of: Perspectives, Research Articles, Correspondence, Clinical Corner, and Reflections. Within these there are a number of types of articles: invited editorials, debates, review articles, original articles, commentaries, letters to the editors, clinical conundrums, clinical curiosities, clinical care, and musings.