Accelerated TMS for Depression: A systematic review and meta-analysis

A. Irem Sonmez, Deniz Doruk Camsari, Aiswarya L. Nandakumar, Jennifer Vande Voort, Simon Kung, Charles P. Lewis, Paul E Croarkin

Research output: Contribution to journalReview article

Abstract

Repetitive transcranial magnetic stimulation (TMS) is now widely available for the clinical treatment of depression, but the associated financial and time burdens are problematic for patients. Accelerated TMS (aTMS) protocols address these burdens and attempt to increase the efficiency of standard TMS. This systematic review and meta-analysis aimed to examine accelerated TMS studies for depressive disorders in accordance with PRISMA guidelines. Inclusion criteria consisted of studies with full text publications available in English describing more than one session of TMS (repetitive or theta burst stimulation) per day. Studies describing accelerated TMS protocols for conditions other than depression or alternative neuromodulation methods, preclinical studies, and neurophysiology studies regarding transcranial stimulation were excluded. Eighteen articles describing eleven distinct studies (seven publications described overlapping samples) met eligibility criteria. A Hedges’ g effect size and confidence intervals were calculated. The summary analysis of three suitable randomized control trials revealed a cumulative effect size of 0.39 (95% CI 0.005–0.779). A separate analysis including open-label trials and active arms of suitable RCTs revealed a g of 1.27 (95% CI 0.902–1.637). Overall, the meta-analysis suggested that aTMS improves depressive symptom severity. In general, study methodologies were acceptable, but future efforts could enhance sham techniques and blinding.

Original languageEnglish (US)
Pages (from-to)770-781
Number of pages12
JournalPsychiatry Research
Volume273
DOIs
StatePublished - Mar 1 2019

Fingerprint

Transcranial Magnetic Stimulation
Meta-Analysis
Depression
Publications
Neurophysiology
Depressive Disorder
Guidelines
Confidence Intervals

Keywords

  • Accelerated TMS
  • Depression
  • Major depressive disorder
  • MDD
  • TMS
  • TRD
  • Treatment resistant depression

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

Cite this

Accelerated TMS for Depression : A systematic review and meta-analysis. / Sonmez, A. Irem; Camsari, Deniz Doruk; Nandakumar, Aiswarya L.; Vande Voort, Jennifer; Kung, Simon; Lewis, Charles P.; Croarkin, Paul E.

In: Psychiatry Research, Vol. 273, 01.03.2019, p. 770-781.

Research output: Contribution to journalReview article

Sonmez, A. Irem ; Camsari, Deniz Doruk ; Nandakumar, Aiswarya L. ; Vande Voort, Jennifer ; Kung, Simon ; Lewis, Charles P. ; Croarkin, Paul E. / Accelerated TMS for Depression : A systematic review and meta-analysis. In: Psychiatry Research. 2019 ; Vol. 273. pp. 770-781.
@article{6c332c32ad6f42949e701193cf7dc49a,
title = "Accelerated TMS for Depression: A systematic review and meta-analysis",
abstract = "Repetitive transcranial magnetic stimulation (TMS) is now widely available for the clinical treatment of depression, but the associated financial and time burdens are problematic for patients. Accelerated TMS (aTMS) protocols address these burdens and attempt to increase the efficiency of standard TMS. This systematic review and meta-analysis aimed to examine accelerated TMS studies for depressive disorders in accordance with PRISMA guidelines. Inclusion criteria consisted of studies with full text publications available in English describing more than one session of TMS (repetitive or theta burst stimulation) per day. Studies describing accelerated TMS protocols for conditions other than depression or alternative neuromodulation methods, preclinical studies, and neurophysiology studies regarding transcranial stimulation were excluded. Eighteen articles describing eleven distinct studies (seven publications described overlapping samples) met eligibility criteria. A Hedges’ g effect size and confidence intervals were calculated. The summary analysis of three suitable randomized control trials revealed a cumulative effect size of 0.39 (95{\%} CI 0.005–0.779). A separate analysis including open-label trials and active arms of suitable RCTs revealed a g of 1.27 (95{\%} CI 0.902–1.637). Overall, the meta-analysis suggested that aTMS improves depressive symptom severity. In general, study methodologies were acceptable, but future efforts could enhance sham techniques and blinding.",
keywords = "Accelerated TMS, Depression, Major depressive disorder, MDD, TMS, TRD, Treatment resistant depression",
author = "Sonmez, {A. Irem} and Camsari, {Deniz Doruk} and Nandakumar, {Aiswarya L.} and {Vande Voort}, Jennifer and Simon Kung and Lewis, {Charles P.} and Croarkin, {Paul E}",
year = "2019",
month = "3",
day = "1",
doi = "10.1016/j.psychres.2018.12.041",
language = "English (US)",
volume = "273",
pages = "770--781",
journal = "Psychiatry Research",
issn = "0165-1781",
publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Accelerated TMS for Depression

T2 - A systematic review and meta-analysis

AU - Sonmez, A. Irem

AU - Camsari, Deniz Doruk

AU - Nandakumar, Aiswarya L.

AU - Vande Voort, Jennifer

AU - Kung, Simon

AU - Lewis, Charles P.

AU - Croarkin, Paul E

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Repetitive transcranial magnetic stimulation (TMS) is now widely available for the clinical treatment of depression, but the associated financial and time burdens are problematic for patients. Accelerated TMS (aTMS) protocols address these burdens and attempt to increase the efficiency of standard TMS. This systematic review and meta-analysis aimed to examine accelerated TMS studies for depressive disorders in accordance with PRISMA guidelines. Inclusion criteria consisted of studies with full text publications available in English describing more than one session of TMS (repetitive or theta burst stimulation) per day. Studies describing accelerated TMS protocols for conditions other than depression or alternative neuromodulation methods, preclinical studies, and neurophysiology studies regarding transcranial stimulation were excluded. Eighteen articles describing eleven distinct studies (seven publications described overlapping samples) met eligibility criteria. A Hedges’ g effect size and confidence intervals were calculated. The summary analysis of three suitable randomized control trials revealed a cumulative effect size of 0.39 (95% CI 0.005–0.779). A separate analysis including open-label trials and active arms of suitable RCTs revealed a g of 1.27 (95% CI 0.902–1.637). Overall, the meta-analysis suggested that aTMS improves depressive symptom severity. In general, study methodologies were acceptable, but future efforts could enhance sham techniques and blinding.

AB - Repetitive transcranial magnetic stimulation (TMS) is now widely available for the clinical treatment of depression, but the associated financial and time burdens are problematic for patients. Accelerated TMS (aTMS) protocols address these burdens and attempt to increase the efficiency of standard TMS. This systematic review and meta-analysis aimed to examine accelerated TMS studies for depressive disorders in accordance with PRISMA guidelines. Inclusion criteria consisted of studies with full text publications available in English describing more than one session of TMS (repetitive or theta burst stimulation) per day. Studies describing accelerated TMS protocols for conditions other than depression or alternative neuromodulation methods, preclinical studies, and neurophysiology studies regarding transcranial stimulation were excluded. Eighteen articles describing eleven distinct studies (seven publications described overlapping samples) met eligibility criteria. A Hedges’ g effect size and confidence intervals were calculated. The summary analysis of three suitable randomized control trials revealed a cumulative effect size of 0.39 (95% CI 0.005–0.779). A separate analysis including open-label trials and active arms of suitable RCTs revealed a g of 1.27 (95% CI 0.902–1.637). Overall, the meta-analysis suggested that aTMS improves depressive symptom severity. In general, study methodologies were acceptable, but future efforts could enhance sham techniques and blinding.

KW - Accelerated TMS

KW - Depression

KW - Major depressive disorder

KW - MDD

KW - TMS

KW - TRD

KW - Treatment resistant depression

UR - http://www.scopus.com/inward/record.url?scp=85061386685&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85061386685&partnerID=8YFLogxK

U2 - 10.1016/j.psychres.2018.12.041

DO - 10.1016/j.psychres.2018.12.041

M3 - Review article

C2 - 31207865

AN - SCOPUS:85061386685

VL - 273

SP - 770

EP - 781

JO - Psychiatry Research

JF - Psychiatry Research

SN - 0165-1781

ER -