ArticleFrontiers in psychiatry2026
Efficacy of repetitive transcranial magnetic stimulation for mild postpartum depression and its association with changes in plasma neuropeptide levels: a prospective, non-randomized controlled study.
Article in Frontiers in psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To evaluate the efficacy of high-frequency rTMS targeting the left DLPFC in mild postpartum depression (PPD) and its association with plasma neuropeptide levels (BDNF, NPY, SP, and oxytocin). Methods: In this prospective, non-randomized controlled study, 120 women with mild PPD received rTMS plus standard care (n = 60; 10 Hz, left DLPFC, 20 sessions over 4 weeks) or standard care alone (n = 60). HAMD-17 and EPDS scores and plasma BDNF, NPY, SP, and OXT (ELISA) were assessed at baseline and weeks 2, 4, and 8. Longitudinal between-group effects were analyzed using linear mixed-effects models, with neuropeptide comparisons corrected by the Benjamini-Hochberg false discovery rate (FDR). Results: Baseline characteristics were largely comparable, except for breastfeeding pattern (P = 0.012). At week 4, the rTMS group had lower HAMD-17 (6.55 vs. 9.30; P < 0.001) and EPDS scores (6.15 vs. 9.27; P < 0.001), with higher response (58.3% vs. 3.3%) and remission rates (71.7% vs. 15.0%; both P < 0.001), although controls also improved. rTMS-treated patients showed elevated plasma BDNF (27.30 vs. 20.27 ng/mL), NPY (114.60 vs. 98.63 pg/mL), and OXT (181.25 vs. 163.00 pg/mL) and reduced SP (52.69 vs. 62.27 pg/mL) at week 4 (all P ≤ 0.009; all surviving FDR correction). The OXT difference persisted after adjustment for baseline OXT and breastfeeding. Within-group neuropeptide changes did not correlate with individual symptom change. Benefits persisted at 8 weeks; adverse events were mild and self-limiting. Conclusions: In this non-randomized study without a sham control, rTMS added to standard care was associated with greater improvement in mild PPD than standard care alone, sustained through 8 weeks. The concurrent modulation of BDNF, NPY, SP, and OXT represents an exploratory association rather than an established mechanism. These preliminary findings require confirmation in multicenter, randomized, sham-controlled trials.
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