Comparative efficacy and cognitive function of magnetic seizure therapy vs. electroconvulsive therapy for major depressive disorder: a systematic review and meta-analysis

Abstract

Magnetic seizure therapy (MST) has established efficacy in the treatment of depression and a growing evidence base in the treatment of depression. We conducted the first systematic review and meta-analysis of the efficacy of MST in anti-depressive treatment and its impact on cognitive function (INPLASY registration number: INPLASY202170061). We searched for controlled trials published in English between 1 January 2001 to 31 December 2020 in PubMed, EMBASE, Cochrane Library, Web of Science, and PsycINFO databases. The evaluation process strictly followed the Cochrane bias risk assessment tool into the literature, and Meta-analysis was performed according to the Cochrane System Reviewer’s Manual. Data from a total of 285 patients from 10 studies were retained in the quantitative synthesis. The results showed no significant difference between MST and ECT in the antidepressant effect (SDM −0.13 [−0.78;0.52]). Compared with ECT, MST showed shorter recovery time (MD −5.67 [−9.75; −1.60]) and reorientation time (MD −14.67 [−27.96; −1.41]); and MST showed less cognitive impairment on the immediate recall of words (SDM 0.80 [0.35;1.25]), delayed recall of words (SDM 0.99 [0.01;0.74]), visual-spatial immediate memory (SDM 0.51 [0.20;0.83]), visual-spatial delayed memory (SDM 0.57 [0.11;1.02]), and the verbal fluency (SDM 0.51 [0.20;0.83]). Our evidence-based study is the first meta-analysis on the efficacy of MST in anti-depressive treatment and its effect on cognitive function. It showed that the curative effect of MST in anti-depressive treatment is equivalent to that of ECT. Besides, depressive patients with MST benefit more from cognitive function compared with ECT.

Comparison of Efficacy and Safety of Magnetic Seizure Therapy and Electroconvulsive Therapy for Depression: A Systematic Review

“…Magnetic seizure therapy (MST) is a new physical therapeutic technique that uses alternating strong magnetic fields to perform generalized seizures for antidepressant-therapeutic purposes [ 12 , 13 , 14 ]. Numerous studies have proved that MST has similar antidepressant efficacy to ECT and few adverse effects in treating major depressive disorder (MDD) [ 15 , 16 , 17 , 18 , 19 ]. Similarly, a recent systematic review reported that MST, as an adjunctive treatment, was efficacious for total psychopathology in schizophrenia [ 20 ].…”

Adjunctive Magnetic Seizure Therapy for Schizophrenia: A Systematic Review

“…However, Kayser et al reported that up to 69% of patients with TRD responded to MST ( 46 ). The latest meta-analysis (10 studies, 285 patients) found that MST produces a similar antidepressant effect to ECT ( 38 ). Furthermore, the optimal parameters of MST need to be determined.…”

“…Accumulating evidence shows that MST is associated with relatively fewer neurocognitive adverse effects than ECT for major depressive disorder (MDD) ( 36 , 37 ). In a recent meta-analysis, MST was associated with shorter recovery and reorientation times and lower cognitive impairment for MDD than ECT ( 38 ). However, inconsistent findings have been reported in two studies on patients with schizophrenia receiving MST treatments ( 20 , 21 ).…”

A feasibility trial of conjoint magnetic seizure therapy and dialectical behavior therapy for suicidal patients with borderline personality disorder and treatment-resistant depression

“…Further, a recent pilot study comparing 100 Hz MST with ECT found no differences in antidepressant effectiveness between the two approaches 12 . Crucially, MST does not appear to be associated with the cognitive side effects observed after ECT 14 , which is a pertinent advantage for individuals with BPD who show a range of cognitive deficits, including in episodic memory 15 .…”