Evidence map›Paper›PMID 41506772›Full record

ArticleBMJ open2026

Adverse effects of non-invasive brain stimulation as a treatment for mental disorders: protocol for a systematic review and meta-analysis.

Celine Koelsch, Tobias Mirlach, Thomas Mehari Kinfe, René Hurlemann, Julian Mutz, Benjamin Selaskowski, Maximilian Kiebs

Abstract read
In one paragraph

Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

7 authors.

Celine KoelschDepartment of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany.
Tobias MirlachDepartment of Psychiatry and Psychotherapy - School of Medicine & Health Sciences Carl von Ossietzky, University of Oldenburg, Oldenburg, Germany.
Thomas Mehari KinfeMannheim Center for Neuromodulation and Neuroprosthetics (MCNN), Department of Neurosurgery, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
René HurlemannDepartment of Psychiatry and Psychotherapy - School of Medicine & Health Sciences Carl von Ossietzky, University of Oldenburg, Oldenburg, Germany.
Julian MutzSocial, Genetic and Developmental Psychiatry, King's College London, London, UK.ORCID http://orcid.org/0000-0001-5308-1957
Benjamin Selaskowski *Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany.
Maximilian Kiebs *Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany m.kiebs@uol.de.ORCID http://orcid.org/0000-0002-4216-2679

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionMental disorders affect nearly one billion people worldwide, posing major challenges to public health. While conventional treatments like psychotherapy and pharmacotherapy are effective for many patients, they are often associated with adverse effects and high non-response rates, underscoring the need for alternative approaches. Non-invasive brain stimulation techniques such as transcranial magnetic stimulation, transcranial electric stimulation and transcranial focused ultrasound stimulation are increasingly used to treat psychiatric conditions. Although these methods show promising efficacy, data on their adverse effects remain fragmented and inconsistently reported. This meta-analysis aims to systematically compare the type and frequency of adverse effects, tolerability, and acceptability across different brain stimulation techniques and mental disorders. The findings will help improve safety monitoring and support more personalised, well-tolerated treatment strategies. METHODS AND ANALYSIS: A systematic literature search of the Embase, MEDLINE(R), AMED (Allied and Complementary Medicine) and APA PsycINFO via OVID will be performed. Eligible studies include randomised controlled trials (RCTs) that compare active treatments or an active treatment with sham control, including both parallel group and cross-over studies, as well as prospective non-randomised studies such as case-control studies and pre-post studies investigating adverse effects of non-invasive brain stimulation in psychiatric populations. Included studies report on the frequency of adverse effects in a standardised manner. Primary outcomes comprise the incidence of specific adverse effects, dropout rates due to adverse effects (tolerability) and overall dropout rates (acceptability). Risk of bias will be assessed using the Cochrane RoB 2.0 tool for RCTs and the NHLBI quality assessment tool for pre-post studies. The quality of case-control studies will be assessed using the Newcastle-Ottawa scale. Provided that sufficient data are available and the network of comparisons is adequately connected, a network meta-analysis will be conducted to compare adverse effects and tolerability across interventions. ETHICS AND DISSEMINATION: No ethical approval is needed to conduct this work. The findings will be submitted for publication in peer-reviewed journals and presented at scientific meetings. PROSPERO REGISTRATION NUMBER: CRD420251164554.

Indexed as

Mental DisordersTranscranial Direct Current StimulationTranscranial Magnetic StimulationHumansNetwork Meta-Analysis as TopicResearch DesignSystematic Reviews as TopicAdverse eventsBrainMeta-AnalysisPSYCHIATRYSystematic Review

Identifiers

PMID41506772
PMCPMC13059895

What OpenQuestion holds

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Registered trials

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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.