Efficacy and safety of high-frequency repetitive transcranial magnetic stimulation for post-stroke depression :A systematic review / 中华物理医学与康复杂志

ABSTRACT

Objective To evaluate the efficacy and safety of high-frequency repetitive transcranial magnetic stimulation (rTMS) in the treatment of post-stroke depression (PSiD).Methods The Cochrane Library,Medline,EMbase and CBMdisc were electronically searched for reports of randomized and controlled trials (RCTs) of high-frequency rTMS in the treatment of PSD before October 2017.Two researchers screened the reports independently,extracted data and assessed the risk of bias in the included studies.The meta-analysis was performed using version 5.1 of the RevMan software.Results A total of 26 RCTs were included,covering 1810 patients with PSD.The metaanalysis showed that the remission rate [relative risk (RR) =2.15,95％CI (1.64,2.83)] and the effectiveness [RR =1.66,95％CI (1.28,2.15)] of high-frequency rTMS group were significantly higher than in the control groups.Compared with the control group,the average Hamilton depression rating scale (HAMD) score of the high-frequency rTMS groups was significantly lower than in the control groups.There was no significant difference in withdrawal between the two groups after treatment [RR =0.55,95％CI (0.18,1.65)].The incidence of headaches was significantly higher in the high-frequency rTMS group than among the controls.Conclusion High-frequency rTMS has a good curative effect and better acceptability for PSD patients,but attention should be given to headaches and other adverse reactions.Due to the limited number of studies and their quality,these conclusions still need to be verified in betterquality studies.