Hsu, Tien-Wei ORCID: 0000-0003-4136-1251 , Yeh, Ta-Chuan, Kao, Yu-Chen, Thompson, Trevor ORCID: 0000-0001-9880-782X , Brunoni, Andre R., Carvalho, Andre F., Hsu, Chih-Wei, Tu, Yu-Kang and Liang, Chih-Sung ORCID: 0000-0003-1138-5586 (2024) The dose-effect relationship of six stimulation parameters with rTMS over left DLPFC on treatment-resistant depression: a systematic review and meta-analysis. Neuroscience and Biobehavioral Reviews:105704. ISSN 0149-7634 (doi:https://doi.org/10.1016/j.neubiorev.2024.105704)

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Abstract

This study aimed to evaluate the association of the six parameters, namely stimulation intensity, stimulation frequency, pulses per session, treatment duration, number of sessions, and total number of pulses with the efficacy of conventional transcranial magnetic stimulation (rTMS) over left dorsolateral prefrontal cortex for patients with treatment-resistant depression (TRD). A random-effects dose-response meta-analysis of blinded randomized controlled trials (RCTs) involving 2391 participants were conducted to examine the dose-effect relationship of six stimulation parameters. Any of the six parameters significantly individually predicted proportion of variance in efficacy: pulses per session (R²=52.7%), treatment duration (R²=51.2%), total sessions (R²=50.9%), frequency (R²=49.6%), total pulses (R²=49.5%), and intensity (R²= 40.4%). Besides, we identified frequency as a potential parameter interacting with the other five parameters, resulting in a significant increase in variance(ΔR2) ranging from 5.0% to 16.7%. Finally, we found that RCTs using frequency > 10 Hz compared to those of 10 Hz showed better dose-effect relationships. We conclude that the six stimulation parameters significantly predict the dose-effect relationship of conventional rTMS on TRD. Besides, higher stimulation frequency, higher stimulation intensity, and adequate number of pulses were associated with treatment efficacy.

Item Type:	Article
Uncontrolled Keywords:	repetitive transcranial magnetic stimulation; major depressive disorder; treatment-resistant; TMS parameters; dose-response meta-analysis
Subjects:	R Medicine > R Medicine (General) R Medicine > RC Internal medicine R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Faculty / School / Research Centre / Research Group:	Faculty of Education, Health & Human Sciences Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development > Centre for Chronic Illness and Ageing Faculty of Education, Health & Human Sciences > School of Human Sciences (HUM)
Last Modified:	16 May 2024 09:44
URI:	http://gala.gre.ac.uk/id/eprint/47145

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