Adjunctive bilateral vs. unilateral or sham repetitive transcranial magnetic stimulation for major depressive disorder or bipolar depression: a meta-analysis of randomized controlled studies

作者：Dong-Bin Cai, Ying-Yan Deng, Yao-Yin Tang, Xiude Qin, Can-Jin Deng, Qiuling Lu, Xiao-Chang Lan, Jian-Jun Wang, Xingbing Huang, Yang Xu · 发表于：European journal of medical research · 年份：2025 · DOI：10.1186/s40001-025-03447-w · 被引用次数：3 · 研究领域：Transcranial Magnetic Stimulation Studies、Electroconvulsive Therapy Studies、Bipolar Disorder and Treatment

Bilateral repetitive transcranial magnetic stimulation (brTMS) has shown promise as a therapeutic approach for depression; however, evidence from existing studies remains inconsistent. To address the concern, a meta-analysis was conducted to examine the efficacy and safety of brTMS in comparison with unilateral repetitive transcranial magnetic stimulation (urTMS) or sham repetitive transcranial magnetic stimulation (srTMS) in treating major depressive disorder (MDD) and bipolar depression (BD). A systematic search covering publications up to May 22, 2024, was performed across four main bibliographic databases (PubMed, EMBASE, Cochrane Library, and PsycINFO) to identify randomized controlled trials (RCTs) assessing the efficacy and safety of brTMS vs. urTMS or srTMS in patients with MDD or BD. Following Cochrane Handbook guidelines, random-effects meta-analyses were employed to derive pooled estimates for primary and secondary outcomes. The analysis included 20 RCTs (8 comparing brTMS to urTMS, 6 comparing brTMS to srTMS, and 6 comparing brTMS to both urTMS and srTMS), encompassing a total of 1666 participants. No significant difference was observed between brTMS and urTMS regarding study-defined response (9 RCTs, 11 study arms, n = 778; RR 1.20, 95% CI 0.83–1.72; Chi2 = 29.76, I2 = 66%; P = 0.34) or study-defined remission (7 RCTs, 8 study arms, n = 684; RR 1.36, 95% CI 0.87–2.12; I2 = 57%; P = 0.18) in patients with MDD or BD. However, when compared to srTMS, brTMS demonstra...