Low-Frequency Repetitive Transcranial Magnetic Stimulation for Children and Adolescents with First-Episode and Drug-Naïve Major Depressive Disorder: A Systematic Review

SOURCE: Frontiers in Psychiatry. 14 (no pagination), 2023. Article Number: 1111754.


AUTHORS: Zheng W.; Lan X.-J.; Qin Z.-J.; Yang X.-H.; Shi Z.-M.

OBJECTIVE: This systematic review of randomized controlled trials (RCTs) was conducted to explore the therapeutic effects and safety of active low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) versus sham LF-rTMS in children and adolescent patients with first-episode and drug-naive (FEDN) major depressive disorder (MDD).

METHOD(S): A systematic literature search was performed, and data were extracted by two independent researchers. The coprimary outcomes were study-defined response and remission.

RESULT(S): A systematic search of the literature yielded 442 references, of which 3 RCTs (130 children and adolescents with FEDN MDD, 50.8% male, and mean age range from 14.5 to 17.5 years) met the inclusion criteria. Among the two RCTs (66.7%, 2/3) examining the effects of LF-rTMS on study-defined response and remission and cognitive function, active LF-rTMS was more efficacious than sham LF-rTMS in terms of study-defined response rate and cognitive function (all p < 0.05) but not regarding study-defined remission rate (all p > 0.05). No significant group differences were found with regard to adverse reactions. None of the included RCTs reported the dropout rate.

CONCLUSION(S): These findings preliminarily found that LF-rTMS could benefit children and adolescents with FEDN MDD in a relatively safe manner, although further studies are warranted.

LINK TO FULL ARTICLE: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10000294/