Evidence map›Paper›PMID 32860557›Full record

SynthesisThe Psychiatric quarterly2020

A Systematic Review and Meta-Analysis of Randomized Sham-Controlled Trials of Repetitive Transcranial Magnetic Stimulation for Bipolar Disorder.

Maggie M K Tee, C H Au

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in The Psychiatric quarterly, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed
1.3field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 31 citations in OpenAlex.

  1. Trial
  2. Treatment of mixed depression with theta-burst stimulation (TBS): results from a double-blind, randomized, sham-controlled clinical trial.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2021
    Trial
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors at 2 institutions in 1 country.

Maggie M K TeeDepartment of Psychiatry, Kwai Chung Hospital, 3-15 Kwai Chung Hospital Road, Hong Kong, China. tmk7251@ha.org.hk.ORCID 0000-0002-0345-2534
C H AuDepartment of Psychiatry, Queen Mary Hospital, Hong Kong, China.
Kwai Chung Hospital · CNQueen Mary Hospital · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRepetitive transcranial magnetic stimulation (rTMS) is effective in treating unipolar depression. However, the efficacy of rTMS in bipolar disorder (BD) is unclear. This meta-analysis aimed to examine the efficacy and tolerability of rTMS for both depressive and manic phases in BD.

methodsMEDLINE, EMBASE, PsycINFO, CENTRAL databases were searched for controlled trials on treatment of BD with rTMS. Primary outcomes included changes in depression or mania scores, response and remission rates. Secondary outcomes included quality of life and functioning assessment. We used random-effects model, Hedge's g, risk differences (RDs) and the number needed to treat (NNT).

resultsEleven randomized sham-controlled studies were included, with a total of 345 patients with BD (bipolar depression = 257, mania = 86, mixed affective = 2). Trials of rTMS in bipolar depression (N = 8) demonstrated small but significant improvement in depression scores [standardized mean difference = 0.302, p < 0.05], compared to control group. Furthermore, rTMS brought a higher remission rate than sham-controls [RD = 0.104 ± 0.044, p < 0.05, NNT = 10; and a trend of greater response rate [RD = 0.074 ± 0.039, p = 0.06]. Results were inconclusive for effect of rTMS in mania. In both depressive and manic groups, no serious adverse events were reported. Risk of treatment-emergent mania appeared low. LIMITATIONS: There was limited number of eligible primary studies, with variable randomization procedures.

conclusionrTMS appears safe and effective in treating bipolar depression. More stringent RCTs are necessary for concrete conclusion about efficacy in mania.

Indexed as

Transcranial Magnetic StimulationBipolar DisorderHumansQuality of LifeRandomized Controlled Trials as TopicTreatment OutcomeBipolar depressionBipolar disorderControlled trialEfficacyManiaTranscranial magnetic stimulation

Identifiers

PMID32860557
OpenAlexW3082372942

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.