TY - JOUR
T1 - Effect of repetitive transcranial magnetic stimulation on depression and cognition in individuals with traumatic brain injury
T2 - a systematic review and meta-analysis
AU - Tsai, Ping Yen
AU - Chen, Yang Ching
AU - Wang, Jia Yi
AU - Chung, Kuo Hsuan
AU - Lai, Chien Hung
N1 - Funding Information:
This work was partially supported by grants from the Ministry of Science and Technology of Taiwan (MOST 109-2221-E-038-006 and MOST 110-2221-E-038-011, and MOST 110-2314-B-038-106), the Higher Education Sprout Project by the Ministry of Education (DP2-110-21121-01-N-02-02), Taipei Medical University Hospital (110 IIT02) and Sunny Brain Tumor and Brain Disease Research and Development Fund from Taipei Medical University, Taipei, Taiwan. This manuscript was edited by Wallace Academic Editing.
Publisher Copyright:
© 2021, The Author(s).
PY - 2021/12
Y1 - 2021/12
N2 - Repetitive transcranial magnetic stimulation (rTMS) is an FDA-approved therapy in major depressive disorder. However, its treatment efficacy on depression after traumatic brain injury (TBI) remains inconclusive. We conducted a meta-analysis to assess the effectiveness of executing rTMS over dorsolateral prefrontal cortex (DLPFC) on depression, cognitive impairment and post-concussion syndrome in individuals with traumatic brain injury. This study contained seven randomized controlled trials that published before April 5, 2020 in PubMed, Embase, Scopus, Cochrane, and Web of Science databases. The rTMS had significant anti-depressant effect (SMD = 1.03, p = 0.02), but the effects dissipated at 1-month follow-up (SMD = 0.39, p = 0.62). In the subgroup analysis, only applying rTMS to left DLPFC area of post-TBI patients showed significant anti-depressant effect (SMD = 0.98, p = 0.04). Moreover, current data observed that rTMS on post-TBI patients possessed substantial improvement in visuospatial memory (SMD = 0.39, p < 0.0001), but wasn’t in processing speed (SMD = − 0.18, p = 0.32) and selective attention (SMD = 0.21, p = 0.31). In addition, the effect of rTMS is not superior to sham on postconcussion syndrome. In conclusion, the short-term antidepressant effect of left DLPFC rTMS in patients with TBI was significant. However, the effectiveness of rTMS on cognition and postconcussion syndrome in patients with post-TBI depression was limited.
AB - Repetitive transcranial magnetic stimulation (rTMS) is an FDA-approved therapy in major depressive disorder. However, its treatment efficacy on depression after traumatic brain injury (TBI) remains inconclusive. We conducted a meta-analysis to assess the effectiveness of executing rTMS over dorsolateral prefrontal cortex (DLPFC) on depression, cognitive impairment and post-concussion syndrome in individuals with traumatic brain injury. This study contained seven randomized controlled trials that published before April 5, 2020 in PubMed, Embase, Scopus, Cochrane, and Web of Science databases. The rTMS had significant anti-depressant effect (SMD = 1.03, p = 0.02), but the effects dissipated at 1-month follow-up (SMD = 0.39, p = 0.62). In the subgroup analysis, only applying rTMS to left DLPFC area of post-TBI patients showed significant anti-depressant effect (SMD = 0.98, p = 0.04). Moreover, current data observed that rTMS on post-TBI patients possessed substantial improvement in visuospatial memory (SMD = 0.39, p < 0.0001), but wasn’t in processing speed (SMD = − 0.18, p = 0.32) and selective attention (SMD = 0.21, p = 0.31). In addition, the effect of rTMS is not superior to sham on postconcussion syndrome. In conclusion, the short-term antidepressant effect of left DLPFC rTMS in patients with TBI was significant. However, the effectiveness of rTMS on cognition and postconcussion syndrome in patients with post-TBI depression was limited.
KW - Adult
KW - Attention/physiology
KW - Brain Injuries, Traumatic/complications
KW - Cognition/physiology
KW - Depression/complications
KW - Female
KW - Humans
KW - Male
KW - Outcome Assessment, Health Care
KW - Post-Concussion Syndrome/etiology
KW - Transcranial Magnetic Stimulation
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U2 - 10.1038/s41598-021-95838-2
DO - 10.1038/s41598-021-95838-2
M3 - Article
C2 - 34417481
AN - SCOPUS:85113223835
SN - 2045-2322
VL - 11
JO - Scientific Reports
JF - Scientific Reports
IS - 1
M1 - 16940
ER -