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Related Experiment Video

Updated: Jul 2, 2026

MRI-guided dmPFC-rTMS as a Treatment for Treatment-resistant Major Depressive Disorder
08:20

MRI-guided dmPFC-rTMS as a Treatment for Treatment-resistant Major Depressive Disorder

Published on: August 11, 2015

Repetitive Transcranial Magnetic Stimulation for Major Depressive Disorder: A Systematic Review and Network

Yue Zhang1, Jinyang Meng1, Xiaobo Liu1

  • 1School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China.

Journal of Evidence-Based Medicine
|July 1, 2026
PubMed
Summary

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This summary is machine-generated.

Theta burst stimulation (TBS) shows the highest probability of being the most effective repetitive transcranial magnetic stimulation (rTMS) for major depressive disorder (MDD). However, more high-quality trials are needed to confirm these findings due to modest effect sizes and overlapping confidence intervals.

Area of Science:

  • Neuroscience
  • Psychiatry
  • Medical Technology

Background:

  • Major depressive disorder (MDD) is a prevalent and debilitating mental health condition.
  • Repetitive transcranial magnetic stimulation (rTMS) is an emerging non-invasive neuromodulation technique for MDD treatment.
  • Various rTMS modalities exist, necessitating a comparative analysis of their efficacy and acceptability.

Purpose of the Study:

  • To systematically review and perform a network meta-analysis (NMA) comparing different rTMS modalities for MDD.
  • To rank the efficacy (response and remission rates) and acceptability (dropout rates) of various rTMS techniques.
  • To provide evidence-based guidance for selecting optimal rTMS interventions for patients with MDD.

Main Methods:

  • A comprehensive search of multiple databases (PubMed, Embase, Cochrane, Web of Science, Chinese databases) was conducted up to October 8, 2025.
Keywords:
MDDRCTsnetwork meta‐analysisrTMSsystematic review

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Last Updated: Jul 2, 2026

MRI-guided dmPFC-rTMS as a Treatment for Treatment-resistant Major Depressive Disorder
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Published on: August 11, 2015

Conventional Repetitive Transcranial Magnetic Stimulation for Depression: A Step-by-Step Protocol
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Conventional Repetitive Transcranial Magnetic Stimulation for Depression: A Step-by-Step Protocol

Published on: November 21, 2025

  • Included were 141 randomized controlled trials (RCTs) involving 10,587 adult participants diagnosed with unipolar MDD.
  • Network meta-analysis (NMA) was performed using Markov chain Monte Carlo simulations, with risk of bias and certainty of evidence assessed using Cochrane ROB 2.0 and CINeMA frameworks, respectively.

    • Main Results:

    • Several rTMS modalities, including accelerated rTMS (aTMS), theta burst stimulation (TBS), bilateral (BL-) rTMS, high-frequency left (HFL-) rTMS, and low-frequency right (LFR-) rTMS, showed significantly greater efficacy than sham stimulation for response rates.
    • TBS demonstrated the highest probability of being the most efficacious modality (SUCRA: 87.2%), particularly in treatment-resistant depression (TRD) subgroups.
    • While TBS, BL-, HFL-, and LFR-rTMS were superior to sham for remission, acceptability varied, with BL-rTMS and deep TMS (dTMS) ranking highest.

    Conclusions:

    • Theta burst stimulation (TBS) emerged as the most promising rTMS modality for major depressive disorder (MDD) based on probabilistic rankings.
    • Despite promising results, modest effect sizes and overlapping confidence intervals highlight the need for caution.
    • High-quality, head-to-head trials directly comparing different rTMS techniques are crucial to validate these findings and refine treatment selection.