Abstract:

Objective To systematically evaluate whether high frequency left-side repetitive transcranial magnetic stimulation (HFL-rTMS) can replace electroconvulsive therapy (ECT) for treating patients with depression. Methods Randomized controlled trials (RCTs) that were relevant to treating depression by HFL-rTMS and ECT and published before August 2013 were retrieved from PubMed, CCTR, Web of Science, Embase, CECDB, CQVIP, CBM, and CNKI. Two researchers independently screened studies and abstracted data according to the inclusion/exclusion criteria. Evaluation indexes included the response rate, remission rate, and drop-out rate. Results Meta analysis was conducted for 8 high quality RCTs. The results of analysis of 8 RCTs showed that the response rate of HFL-rTMS for treating the depression was equivalent to that of ECT (OR=0.83, 95%CI: 0.53～1.30, P=0.420). The results of analysis of 6 RCTs showed that the remission rate of HFL-rTMS was equivalent to that of ECT (OR=0.64, 95%CI: 0.36～1.13, P=0.120). The results of analysis of 3 RCTs showed that the drop-out rate of HFL-rTMS was equivalent to that of ECT (OR=0.39, 95%CI: 0.14～1.11, P=0.080). No significant heterogeneity and publication bias existed in meta analyses. Conclusion HFL-rTMS is a potential method for replacing the treatment of depression by ECT.

Key words: repetitive transcranial magnetic stimulation, electroconvulsive therapy, depression, meta analysis