Symptom Provocation and Clinical Response to Transcranial Magnetic Stimulation

作者：Danielle M. Bello, Megan Jones, Ishaan Gadiyar, Laura Artim, Sophia H. Blyth, Roscoe O. Brady, Simon Vandekar, Heather Burrell Ward · 发表于：JAMA Psychiatry · 年份：2025 · DOI：10.1001/jamapsychiatry.2025.0792 · 被引用次数：7 · 研究领域：Transcranial Magnetic Stimulation Studies、Electroconvulsive Therapy Studies、Pain Management and Treatment

Importance: Transcranial magnetic stimulation (TMS), a form of noninvasive brain stimulation used to treat major depressive disorder, obsessive-compulsive disorder (OCD), and nicotine dependence, has well-established state-dependent effects on brain circuitry. However, a major question for TMS remains: does brain state affect clinical response? Objective: To quantify the association between symptom provocation and clinical response to TMS for OCD and nicotine dependence, the only Food and Drug Administration-cleared TMS indications with symptom provocation. Data Sources: PubMed, CINAHL, Embase, PsycInfo until August 30, 2024. Study Selection: Randomized clinical trials of TMS for OCD or nicotine dependence with a clinical outcome. Of 600 studies identified, 71 met inclusion criteria. Data Extraction and Synthesis: Data extraction was completed independently by 2 extractors and cross-checked by a third. Standardized mean difference (SMD) and SE were estimated via Hedges g and synthesized data in a 3-level random-effects meta-analysis. Study data were analyzed from August 2023 to March 2025. Main Outcomes and Measures: Primary outcomes were clinical response measures. Results: A total of 71 studies met inclusion criteria and included 3246 participants (mean [SD] age; 37.8 [8.0] years; mean [SD] percentage female, 44.1% [17.2%]). Included in the meta-analysis were 63 studies with 2998 participants. For OCD studies, active TMS was associated with better clinical response than sha...