Efficacy and safety of repetitive transcranial magnetic stimulation in children and adolescents with depression: A systematic review and preliminary meta-analysis

Qiu, Hui; Liang, Kaili; Lu, Lu; Gao, Yingxue; Li, Hailong; Hu, Xinyue; Xing, Haoyang; Huang, Xiaoqi; Gong, Qiyong

doi:10.1016/j.jad.2022.09.060

Cited by 21 publications

(9 citation statements)

References 59 publications

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“…Huanzhong Liu, Chaohu Hospital of Anhui Medical University, China recurrence, suicide, and long-term psychosocial impairment in adulthood (2,(4)(5)(6). Therefore, improvements in treating MDD among children and adolescents should positively affect public health.…”

Section: Open Access Edited Bymentioning

confidence: 99%

“…The search terms are listed in Appendix S1. Additionally, we manually searched reference lists of previous reviews (2,9,32) and the included RCTs (29)(30)(31) on active LF-rTMS versus sham LF-rTMS for children and adolescent patients with FEDN MDD.…”

Section: Search Strategy and Selection Criteriamentioning

confidence: 99%

“…Major depressive disorder (MDD), as a leading cause of global disease burden (1), affects approximately 5-15% of children and adolescents (2). Children and adolescents with MDD are usually related to school dropout, pregnancy/parenthood, and unemployment (3).…”

Section: Introductionmentioning

confidence: 99%

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Low-frequency repetitive transcranial magnetic stimulation for children and adolescents with first-episode and drug-naïve major depressive disorder: A systematic review

et al. 2023

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ObjectiveThis systematic review of randomized controlled trials (RCTs) was conducted to explore the therapeutic effects and safety of active low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) versus sham LF-rTMS in children and adolescent patients with first-episode and drug-naïve (FEDN) major depressive disorder (MDD).MethodsA systematic literature search was performed, and data were extracted by two independent researchers. The coprimary outcomes were study-defined response and remission.ResultsA systematic search of the literature yielded 442 references, of which 3 RCTs (130 children and adolescents with FEDN MDD, 50.8% male, and mean age range from 14.5 to 17.5 years) met the inclusion criteria. Among the two RCTs (66.7%, 2/3) examining the effects of LF-rTMS on study-defined response and remission and cognitive function, active LF-rTMS was more efficacious than sham LF-rTMS in terms of study-defined response rate and cognitive function (all p < 0.05) but not regarding study-defined remission rate (all p > 0.05). No significant group differences were found with regard to adverse reactions. None of the included RCTs reported the dropout rate.ConclusionThese findings preliminarily found that LF-rTMS could benefit children and adolescents with FEDN MDD in a relatively safe manner, although further studies are warranted.

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Section: Open Access Edited Bymentioning

confidence: 99%

Section: Search Strategy and Selection Criteriamentioning

confidence: 99%

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Low-frequency repetitive transcranial magnetic stimulation for children and adolescents with first-episode and drug-naïve major depressive disorder: A systematic review

et al. 2023

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“…In research on depression, Qiu et al’s meta-analysis showed that rTMS can benefit children and adolescents with major depression in a relatively safe manner ( 48 ). Zheng et al.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of non-invasive brain stimulation in combination with antidepressants in adolescents with depression: a systematic review and meta-analysis

Li,

Liu

2024

Front. Psychiatry

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ObjectiveNon-invasive brain stimulation (NIBS) is beneficial to adult patients with depression, but its safety and efficacy in combination with antidepressants in children and adolescents with depression are not clear. We conducted a preliminary meta-analysis to objectively evaluate its clinical effect and provide information for future research and clinical practice.MethodsPubMed, Cochrane Library, Embase, and Web of Science were searched systematically to find clinical trials published in English before April 11, 2023. Stata software was used for meta-analysis, and random or fixed effect models were used to combine effect sizes.ResultsNine studies were eligible and included (n = 393). No articles about children were included in the analysis. The results showed that the remission rate was 40% (95% confidence interval [CI]: 13% to 71%). The scores of Children’s Depression Rating Scale (CRDS) and Hamilton’s depression scale (HAMD) significantly decreased compared to baseline value (MD = -27.04, 95% CI: -30.95, -23.12 and MD = -12.78, 95% CI: -19.55 to -6.01). In addition, the incidence of all adverse events was 13% (95% CI: 5%, 23%), and all were minor pain-related events.ConclusionThe combination of NIBS and antidepressants has been shown to notably alleviate depressive symptoms in adolescents, offering a considerable level of safety. This therapeutic synergy is particularly effective in patients with major depressive disorder, where repetitive transcranial magnetic stimulation augmented with antidepressants can enhance the amelioration of depressive symptoms.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023442215, PROSPERO CRD42023442215.

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“…Preliminary findings suggested that TMS can mitigate suicidal ideation in adolescents through the treatment and improvement of depressive symptom severity [ 162 ]. Very recently, a repetitive TMS (rTMS) study aimed to treat adolescents with NDD demonstrated changes in brain activities and functional connectivity [ 163 ]. In particular, changes in the left subgenual anterior cingulate cortex and in the right middle cingulate cortex seem to be associated with an improvement in depressive symptoms, suggesting possible neural targets for further clinical trials.…”

Section: Suicide In the Nddmentioning

confidence: 99%

Neurodevelopmental Disorders and Suicide: A Narrative Review

Gagliano,

Costanza,

Di Modica

et al. 2024

JCM

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Specific risk factors for self-harm and suicide in children and adolescents with neurodevelopmental disorders (NDD) may differ from those in the general population within this age range. In the present review paper, we conducted a narrative analysis of the literature, aiming to establish a connection between suicide and affective disorders in children and adolescents with NDD. Emotion dysregulation (ED) as an individual factor and adverse childhood experiences (ACE) as environmental factors are discussed as risk factors for suicidality in all individuals with NDD. We propose a theoretical model in which ED and ACE can directly lead to self-harm or suicide, directly or indirectly by interacting with depressive spectrum disorders. Additionally, we suggest that specific risk factors are more frequently associated with each of the neurodevelopmental disorders listed in the DSM-V. This review underlines the key points useful to improve the knowledge of the trajectory leading to suicide risk in NDDs with the purpose to facilitate the early identification of the suicide risk.

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Efficacy and safety of repetitive transcranial magnetic stimulation in children and adolescents with depression: A systematic review and preliminary meta-analysis

Cited by 21 publications

References 59 publications

Low-frequency repetitive transcranial magnetic stimulation for children and adolescents with first-episode and drug-naïve major depressive disorder: A systematic review

Low-frequency repetitive transcranial magnetic stimulation for children and adolescents with first-episode and drug-naïve major depressive disorder: A systematic review

Efficacy and safety of non-invasive brain stimulation in combination with antidepressants in adolescents with depression: a systematic review and meta-analysis

Neurodevelopmental Disorders and Suicide: A Narrative Review

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