Repetitive Transcranial Magnetic Stimulation as an Augmentative Strategy for Treatment-resistant Depression

A Meta-analysis of Randomized, Double-blind and Sham-Controlled Study

Bangshan Liu; Yan Zhang; Li Zhang; Lingjiang Li


BMC Psychiatry. 2014;14(342) 

In This Article


This study showed that augmentative rTMS was significantly superior to sham condition in TRD treatment, and the two groups did not differ significantly in dropout rates or side effects, indicating the advantage of rTMS in the efficacy and acceptability for clinical treatment of TRD. As the number of included RCTs was relatively low and the heterogeneity of RCTs in subgroup analysis is higher than expected by chance, we did not explore the potential confounding factors which may influence the effect of rTMS. Future studies should have more rigid design, such as reporting the method of allocation concealment and blinding in details, carrying out longer non-interventive follow-up to make clear of long-term efficacy of rTMS, and improving the design of sham condition to alleviate placebo effect further. Additionally, combination with neuroimaging technique for identifying the best stimulation location is expected.