Repetitive transcranial magnetic stimulation for fibromyalgia patients: A Systematic Review with Meta-Analysis

Pain Medicine ◽  
2021 ◽  
Author(s):  
Pingping Sun ◽  
Lei Fang ◽  
Jianzhong Zhang ◽  
Yang Liu ◽  
Guodong Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Transcranial Magnetic Stimulation ◽  
Confidence Interval ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Meta Analysis ◽  
Mean Difference ◽  
Significant Difference ◽  
Standardized Mean Difference

Abstract Objective Fibromyalgia is a poorly understood pain syndrome. Repetitive transcranial magnetic stimulation is a noninvasive brain stimulation therapy and is commonly applied for the management of fibromyalgia. However, controversy regarding its efficacy remains. Therefore, a meta-analysis was conducted to evaluate the effectiveness of repetitive transcranial magnetic stimulation (rTMS) for fibromyalgia syndrome. Method Four medical databases and one physiotherapy database were screened for randomized controlled trials. A systematic review and meta-analysis was performed. Numerical Pain Rating Scale (NPRS), Beck Depression Inventory (BDI), Hospital Anxiety and Depression Scale (HADS) anxiety score, Pain Catastrophizing Scale (PCS), Fatigue Severity Scale (FSS), Short Form-36 general health survey mental score, and Fibromyalgia Impact Questionnaire (FIQ) were set as outcome measures. Results Analysis of 14 studies and 433 participants indicated that rTMS exerted more favorable effects on the NPRS than sham rTMS after treatment (standardized mean difference = −0.49, 95% confidence interval = −0.86 to − 0.13, P = 0.008, I2 = 68%) and FIQ (standardized mean difference = −0.50, 95% confidence interval = −0.75 to − 0.25, P = 0.0001, I2 = 28%). However, the BDI, FSS, PCS, mood index, and HADS scores showed no significant difference compared with sham rTMS after treatment. The mean methodological quality of included studies was an acceptable score of 8.5 based on the PEDro scale, suggesting the validity of our conclusions. Conclusion This study demonstrated that rTMS relieved pain and enhanced quality of life of patients with fibromyalgia; however, it did not improve anxiety, depression, and other symptoms based on current reports.

scholarly journals Blinding integrity in randomized sham-controlled trials of repetitive transcranial magnetic stimulation for major depression: a systematic review and meta-analysis

2013 ◽  
Vol 16 (5) ◽  
pp. 1173-1181 ◽  
Author(s):  
Marcelo T. Berlim ◽  
Hannah J. Broadbent ◽  
Frederique Van den Eynde
Keyword(s):  
Systematic Review ◽  
Transcranial Magnetic Stimulation ◽  
Major Depression ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Treatment Allocation ◽  
Significant Difference

Abstract Repetitive transcranial magnetic stimulation (rTMS) is a safe and effective treatment for major depression (MD). However, the perceived lack of a suitable sham rTMS condition might have compromised the success of blinding procedures in clinical trials. Thus, we conducted a systematic review and meta-analysis of randomized, double-blind and sham-controlled trials (RCTs) on high frequency (HF-), low frequency (LF-) and bilateral rTMS for MD. We searched the literature from January 1995 to July 2012 using Medline, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials and Scopus. The main outcome measure was participants' ability to correctly guess their treatment allocation at study end. We used a random-effects model and risk difference (RD). Overall, data were obtained from seven and two RCTs on HF- and bilateral rTMS, respectively. No RCT on LF-rTMS reporting on blinding success was found. HF- and bilateral rTMS trials enrolled 396 and 93 depressed subjects and offered an average of approximately 13 sessions. At study end, 52 and 59% of subjects receiving HF-rTMS and sham rTMS were able to correctly guess their treatment allocation, a non-significant difference (RD = −0.04; z = −0.51; p = 0.61). Furthermore, 63.3 and 57.5% of subjects receiving bilateral and sham rTMS were able to correctly guess their treatment allocation, also a non-significant difference (RD = 0.05; z = 0.49; p = 0.62). In addition, the use of angulation and sham coil in HF-rTMS trials produced similar results. In summary, existing sham rTMS interventions appear to result in acceptable levels of blinding regarding treatment allocation.

scholarly journals Repetitive transcranial magnetic stimulation treatment for peripartum depression: systematic review & meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hyune June Lee ◽  
Sung Min Kim ◽  
Ji Yean Kwon
Keyword(s):  
Systematic Review ◽  
Transcranial Magnetic Stimulation ◽  
Side Effects ◽  
Electroconvulsive Therapy ◽  
Effect Size ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Peripartum Depression

Abstract Background Peripartum depression is a common disorder with very high potential hazards for both the patients and their babies. The typical treatment options include antidepressants and electroconvulsive therapy. However, these treatments do not ensure the safety of the fetus. Recently, repetitive transcranial magnetic stimulation has emerged as a promising treatment for neuropathies as well as depression. Nevertheless, many studies excluded pregnant women. This systematic review was conducted to confirm whether repetitive transcranial magnetic stimulation was a suitable treatment option for peripartum depression. Methods We performed a systematic review that followed the PRISMA guidelines. We searched for studies in the MEDLINE, PsycINFO, EMBASE, and Cochrane library databases published until the end of September 2020. Eleven studies were selected for the systematic review, and five studies were selected for quantitative synthesis. Data analysis was conducted using Comprehensive Meta-Analysis 3 software. The effect size was analyzed using the standardized mean difference, and the 95% confidence interval (CI) was determined by the generic inverse variance estimation method. Results The therapeutic effect size of repetitive transcranial magnetic stimulation for peripartum depression was 1.394 (95% CI: 0.944–1.843), and the sensitivity analysis effect size was 1.074 (95% CI: 0.689–1.459), indicating a significant effect. The side effect size of repetitive transcranial magnetic stimulation for peripartum depression was 0.346 (95% CI: 0.214–0.506), a meaningful result. There were no severe side effects to the mothers or fetuses. Conclusions From various perspectives, repetitive transcranial magnetic stimulation can be considered an alternative treatment to treat peripartum depression to avoid exposure of fetuses to drugs and the severe side effects of electroconvulsive therapy. Further research is required to increase confidence in the results.

scholarly journals Minimally invasive versus conventional surgery of the ascending aorta and root: a systematic review and meta-analysis

2019 ◽  
Vol 57 (1) ◽  
pp. 8-17 ◽  
Author(s):  
Tom A Rayner ◽  
Sean Harrison ◽  
Paul Rival ◽  
Dominic E Mahoney ◽  
Massimo Caputo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Renal Impairment ◽  
Minimally Invasive ◽  
Risk Ratio ◽  
Observational Studies ◽  
Meta Analysis ◽  
Ascending Aorta ◽  
Mean Difference ◽  
Standardized Mean Difference

Summary Limited uptake of minimally invasive surgery (MIS) of the aorta hinders assessment of its efficacy compared to median sternotomy (MS). The objective of this systematic review is to compare operative and perioperative outcomes for MIS versus MS. Online databases Medline, EMBASE, Cochrane Library and Web of Science were searched from inception until July 2018. Both randomized and observational studies of patients undergoing aortic root, ascending aorta or aortic arch surgery by MIS versus MS were eligible for inclusion. Primary outcomes were 30-day mortality, reoperation for bleeding, perioperative renal impairment and neurological events. Intraoperative and postoperative timing measures were also evaluated. Thirteen observational studies were included comparing 1101 MIS and 1405 MS patients. The overall quality of evidence was very low for all outcomes. Mortality and the incidence of stroke were similar between the 2 cohorts. Meta-analysis demonstrated increased length of cardiopulmonary bypass (CPB) time for patients undergoing MS [standardized mean difference 0.36, 95% confidence interval (CI) 0.15–0.58; P = 0.001]. Patients receiving MS spent more time in hospital (standardized mean difference 0.30, 95% CI 0.17–0.43; P < 0.001) and intensive care (standardized mean difference 0.17, 95% CI 0.06–0.27; P < 0.001). Reoperation for bleeding (risk ratio 1.51, 95% CI 1.06–2.17; P = 0.024) and renal impairment (risk ratio 1.97, 95% CI 1.12–3.46; P = 0.019) were also greater for MS patients. There was substantial heterogeneity in meta-analyses for CPB and aortic cross-clamp timing outcomes. MIS may be associated with improved early clinical outcomes compared to MS, but the quality of the evidence is very low. Randomized evidence is needed to confirm these findings.

scholarly journals Effect of repetitive transcranial magnetic stimulation (rTMS) for insomnia: a protocol for a systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029206 ◽  
Author(s):  
Yu He ◽  
Nianyi Sun ◽  
Zhiqiang Wang ◽  
Wenchen Zou
Keyword(s):  
Systematic Review ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Data Extraction ◽  
Meta Analysis ◽  
Bibliographic Databases ◽  
Manual Search ◽  
Ethical Approval ◽  
Randomised Controlled

IntroductionRepetitive transcranial magnetic stimulation (rTMS), a non-invasive brain stimulation approach, might be a promising technique in the management of insomnia. A systematic review of the available literature on this topic is warranted. The systematic review described in this protocol aims to investigate the efficacy of rTMS as a physical therapy in patients with insomnia.Methods and analysisThis protocol was developed in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. We will retrieve relevant literatures across the following electronic bibliographic databases: CENTRAL, PubMed, EMBASE, PsycINFO, CINAHL, PEDro, CBM, CNKI, WANFANG and VIP. A manual search of the reference lists of all relevant articles will be performed for any additional studies. We will include randomised controlled trials published in English and Chinese examining efficacy of rTMS on patients with insomnia. Two reviewers will independently complete the article selection, data extraction and rating. PEDro scale will be used to assess the methodological quality of the included studies. Narrative and quantitative synthesis will be done accordingly.Ethics and disseminationEthical approval will not be required for this review. The results of this review will be disseminated in a peer-review journal.PROSPERO registration numberCRD42018115033.

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