Berlim, M. T., McGirr, A., dos Santos, N. R., Tremblay, S., & Martins, R. (2017). Efficacy of theta burst stimulation (TBS) for major depression: An exploratory meta-analysis of randomized and sham-controlled trials. Journal of Psychiatric Research, 90, 102-109.
Data from 221 participants with MDD, across 5 randomized, single/double-blinded, sham-controlled trials were assessed regarding the efficacy of TBS over the DLPFC in terms of response and remission (Hamilton Depression Rating Scale). The efficacy of left unilateral intermittent TBS (iTBS), right unilateral continuous TBS (cTBS), and bilateral TBS (right cTBS and left iTBS) were compared. The number of sessions ranged from 10 over two weeks to 30 over 6 weeks across studies. Significantly more active TBS participants were classified as responders compared to sham participants (35.6% versus 17.5%, respectively). This translated into a number needed to treat (NNT) of 6, suggesting every 1 in 6 patients should respond to TBS. However, groups did not differ in remission rates, although this may relate to the active TBS groups having significantly greater baseline depression severity. Further, only an average of 17 sessions of TBS were performed, which is less than the standard 20-30 sessions. Bilateral TBS and left iTBS were associated with a significant response, whilst cTBS was comparable to sham. The drop-out rates did not differ significantly between active TBS (4.2%) or sham (7.8%), suggesting active TBS is well-tolerated.
*For original abstract/publication see the link below.