Efficacy and Safety of Neuromodulation Techniques in Depression Treatment: A Systematic Review and Meta-Analysis.

IF 1.6 4区医学 Q4 PHARMACOLOGY & PHARMACY

Psychiatry and Clinical Psychopharmacology Pub Date : 2025-09-18 DOI:10.5152/pcp.2025.241065

Yajie Wan, Kaili Fan, Xinwu Ye

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Abstract

Background: Depression, particularly major depressive disorder, is a leading cause of disability, with limited diagnostic tools based on objective biomarkers. Advances in neurostimulation techniques, such as intermittent theta burst stimulation (iTBS) and repetitive transcranial magnetic stimulation (rTMS), show promise in improving treatment outcomes. However, their comparative efficacy and safety remain unclear.

Methods: A comprehensive literature search was conducted in databases (PubMed, Embase, Wiley, Web of Science, China National Knowledge Infrastructure (CNKI) database, Wanfang, and VIP) up to September 3, 2024. Data from eligible randomized controlled trials were pooled for meta-analysis, comparing iTBS and rTMS on remission and response rates, as well as adverse effects, using RevMan software. Sensitivity analyses were performed.

Results: This meta-analysis included 10 studies. No significant difference was found between iTBS and rTMS in remission (OR=1.01, 95% CI: 0.72-1.42, P=.03) or response rates (OR=1.02, 95% CI: 0.76-1.35, P=.91). The incidence of adverse effects was similar (OR=1.17, 95% CI: 0.83-1.66, P=.38). Compared to sham stimulation, rTMS showed significantly higher remission (OR=4.84, 95% CI: 2.66-8.80, P < .001) and response rates (OR=3.92, 95% CI: 2.08-7.37, P < .001).

Conclusion: Both iTBS and rTMS have similar efficacy and safety. Further validation of multimodal neuroimaging biomarkers is needed to enhance personalized treatment strategies.

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神经调节技术在抑郁症治疗中的有效性和安全性：一项系统综述和荟萃分析。

背景：抑郁症，尤其是重度抑郁症，是致残的主要原因，基于客观生物标志物的诊断工具有限。神经刺激技术的进步，如间歇性θ波爆发刺激（iTBS）和重复经颅磁刺激（rTMS），显示出改善治疗结果的希望。然而，它们的相对疗效和安全性仍不清楚。方法：截至2024年9月3日，在PubMed、Embase、Wiley、Web of Science、CNKI、万方、VIP等数据库中进行全面的文献检索。采用RevMan软件对符合条件的随机对照试验的数据进行荟萃分析，比较iTBS和rTMS在缓解率和反应率以及不良反应方面的差异。进行敏感性分析。结果：本荟萃分析包括10项研究。iTBS和rTMS在缓解（OR=1.01, 95% CI: 0.72-1.42， P= 0.03）或缓解率（OR=1.02, 95% CI: 0.76-1.35， P= 0.91）方面无显著差异。两组不良反应发生率相似（OR=1.17, 95% CI: 0.83-1.66， P= 0.38）。与假刺激相比，rTMS的缓解率（OR=4.84, 95% CI: 2.66 ~ 8.80, P < .001）和有效率（OR=3.92, 95% CI: 2.08 ~ 7.37, P < .001）显著高于假刺激。结论：iTBS与rTMS具有相似的疗效和安全性。需要进一步验证多模态神经成像生物标志物，以增强个性化治疗策略。

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来源期刊

Psychiatry and Clinical Psychopharmacology Medicine-Psychiatry and Mental Health

CiteScore

1.00

自引率

14.30%

发文量

期刊介绍： Psychiatry and Clinical Psychopharmacology aims to reach a national and international audience and will accept submissions from authors worldwide. It gives high priority to original studies of interest to clinicians and scientists in applied and basic neurosciences and related disciplines. Psychiatry and Clinical Psychopharmacology publishes high quality research targeted to specialists, residents and scientists in psychiatry, psychology, neurology, pharmacology, molecular biology, genetics, physiology, neurochemistry, and related sciences.