Background

There is evidence that repetitive transcranial magnetic stimulation (rTMS) is effective for treating adult depression. However, it remains unclear whether rTMS is an effective treatment for adolescent depression. This systematic review examines the existing literature on the effectiveness and acceptability of rTMS in the treatment of adolescent depression.

Methods

After protocol registration (PROSPERO) we searched PubMed, Embase, PsycINFO, WoS and CENTRAL databases and the grey literature. We included studies that used rTMS in adolescents aged 12–25 years old who had a clinical diagnosis of depression. Study quality was assessed using the Newcastle-Ottawa Scale.

Results

Fourteen studies were identified, which included 8 open-trial studies (N =142 participants) and six studies which performed further post-hoc /follow-up analyses on these open-trial datasets. All studies suffered from multiple biases but reported that rTMS treatment reduced depression scores in adolescents. A single study on theta burst stimulation also found a positive effect. No study to date includes a sham control. Reported side effects of rTMS included scalp pain, headache and dizziness.

Limitations

Study methodologies precluded a meta-analysis.

Conclusions

The current literature signals that rTMS could reduce adolescent depressive symptoms. However, sham controlled randomized trials are needed. These findings suggest that rTMS may be a promising treatment option for adolescents with depression.

中文翻译：

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重复经颅磁刺激 (rTMS) 治疗青春期抑郁症：系统评价

背景

有证据表明重复经颅磁刺激 (rTMS) 可有效治疗成人抑郁症。然而，目前尚不清楚 rTMS 是否是治疗青少年抑郁症的有效方法。本系统评价检查了关于 rTMS 治疗青少年抑郁症的有效性和可接受性的现有文献。

方法

在协议注册 (PROSPERO) 之后，我们搜索了 PubMed、Embase、PsycINFO、WoS 和 CENTRAL 数据库以及灰色文献。我们纳入了在临床诊断为抑郁症的 12-25 岁青少年中使用 rTMS 的研究。使用纽卡斯尔-渥太华量表评估研究质量。

结果

确定了 14 项研究，其中包括 8 项开放试验研究（N = 142 名参与者）和 6 项研究，这些研究对这些开放试验数据集进行了进一步的事后/随访分析。所有研究都存在多种偏见，但报告称 rTMS 治疗降低了青少年的抑郁评分。一项关于 theta 爆发刺激的单一研究也发现了积极的影响。迄今为止没有研究包括假控制。报告的 rTMS 副作用包括头皮疼痛、头痛和头晕。

限制

研究方法排除了荟萃分析。

结论

目前的文献表明 rTMS 可以减少青少年抑郁症状。然而，需要进行假对照随机试验。这些发现表明，rTMS 可能是青少年抑郁症的一种有希望的治疗选择。