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

Area of Science:

• Neuroscience
• Psychiatry
• Clinical Research

Background:

• Repetitive transcranial magnetic stimulation (TMS) is a recognized depression treatment.
• Standard TMS protocols present financial and time burdens for patients.
• Accelerated TMS (aTMS) protocols aim to enhance treatment efficiency.

Purpose of the Study:

• To systematically review and meta-analyze studies on accelerated TMS for depressive disorders.
• To assess the efficacy of aTMS in improving depressive symptom severity.
• To adhere to PRISMA guidelines for systematic reviews and meta-analyses.

Main Methods:

• Systematic literature search for full-text English publications on aTMS for depression.
• Inclusion of studies with multiple TMS sessions per day (repetitive or theta burst).
• Exclusion of studies on non-depressive conditions, alternative neuromodulation, preclinical, or neurophysiology research.
• Calculation of Hedges' g effect size and confidence intervals.
• Analysis of randomized controlled trials (RCTs) and open-label trials.

Main Results:

• A meta-analysis of three RCTs showed a cumulative effect size of 0.39 (95% CI 0.005-0.779).
• An expanded analysis including open-label trials and active arms yielded an effect size of 1.27 (95% CI 0.902-1.637).
• The findings suggest aTMS is effective in improving depressive symptom severity.

Conclusions:

• Accelerated TMS (aTMS) demonstrates efficacy in treating depressive disorders.
• The study highlights aTMS as a potentially more efficient alternative to standard TMS.
• Future research should focus on refining sham techniques and blinding in aTMS studies.