Comparative Efficacy and Acceptability of 3 Repetitive Transcranial Magnetic Stimulation Devices for Depression: A Meta-Analysis of Randomized, Sham-Controlled Trials.
Yuki Matsuda, Ryuichi Yamazaki, Taro Kishi, Nakao Iwata, Masahiro Shigeta, Shinsuke Kito
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引用次数: 0
Abstract
Introduction: Repetitive transcranial magnetic stimulation (rTMS) has been employed worldwide for therapy-resistant depression. The Food and Drug Administration has approved a number of therapeutic devices for treating major depressive disorder; however, no studies have examined the differences in efficacy and acceptability among commercially available stimulation devices. The aim of our study was to compare the efficacy and acceptability of 3 stimulation devices (NeuroStar, MagPro, and Magstim) for depressive disorders.
Methods: Our study included 31 randomized sham-controlled trials of high-frequency rTMS included in the network meta-analysis by Brunoni. We calculated the risk ratio and 95% confidence intervals, comparing each device with sham for the endpoints of response rate, remission rate, and all-cause discontinuation. We then analyzed the differences among the devices in effect size for those endpoints.
Results: After determining the effect sizes for the endpoints, we found no statistically significant subgroup differences in the response rates, all-cause discontinuation, or remission rates among the devices (p = 0.12, p = 0.84, and p = 0.07, respectively).
Conclusion: Our results suggest similar efficacy and acceptability for the 3 stimulation devices. Future studies need to perform head-to-head comparisons of the efficacy and acceptability of the stimulation devices for treating depression using the same stimulation protocols.
重复经颅磁刺激(rTMS)已在世界范围内用于治疗难治性抑郁症。美国食品和药物管理局(Food and Drug Administration)已经批准了一些用于治疗重度抑郁症的治疗设备;然而,目前还没有研究调查市面上可买到的刺激装置在功效和可接受性上的差异。本研究的目的是比较3种刺激装置(NeuroStar、MagPro和Magstim)治疗抑郁症的疗效和可接受性。方法:本研究纳入31项随机假对照高频rTMS试验,纳入Brunoni网络meta分析。我们计算了风险比和95%置信区间,将每个装置与假手术进行比较,以确定缓解率、缓解率和全因停药的终点。然后,我们分析了这些终点的效应大小在设备之间的差异。结果:在确定终点的效应大小后,我们发现在不同装置之间的反应率、全因停药率或缓解率没有统计学上显著的亚组差异(p = 0.12、p = 0.84和p = 0.07)。结论:3种刺激装置疗效相近,可接受性较好。未来的研究需要对使用相同的刺激方案治疗抑郁症的刺激装置的有效性和可接受性进行正面比较。
期刊介绍:
ACS Applied Bio Materials is an interdisciplinary journal publishing original research covering all aspects of biomaterials and biointerfaces including and beyond the traditional biosensing, biomedical and therapeutic applications.
The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrates knowledge in the areas of materials, engineering, physics, bioscience, and chemistry into important bio applications. The journal is specifically interested in work that addresses the relationship between structure and function and assesses the stability and degradation of materials under relevant environmental and biological conditions.