Original Title: Indicaciones de la Estimulación Magnética Transcraneal: trastorno depresivo mayor y otros trastornos

Authors' objectives: To review the therapeutic indications of rTMS for depression and other disorders such as schizophrenia, obsessive compulsive disorder, chronic pain, stroke, and Parkinson's disease, based on current scientific evidence. To evaluate the efficacy and safety of rTMS for depression and other neurological and psychiatric diseases which have been investigated for their therapeutic potential.

Authors' results and conclusions: RESULTS: A total of 673 references were found in the electronic databases, and 456 were considered after the elimination of duplicates; 225 were assessed in full-text for possible inclusion. Finally, a total of 33 metaanalysis were included: 17 in depression, 7 in schizophrenia, 4 in chronic pain, 2 in stroke, 2 in Parkinson disease, and 1 in obsessive-compulsive disorder. CONCLUSIONS: Regarding the effectiveness of rTMS, statistically significant effects were obtained in most evaluated disorders. However, except for the overall effect of the technique on the short-term reduction of depressive symptoms, the evidence is insufficient to establish its efficacy in the treatment of various disorders examined, because it comes from studies with small samples that yield imprecise estimations. In many cases the results of the reviews are not consistent, observing a statistically significant heterogeneity between studies. Predictors or moderators that significantly explain this heterogeneity has not been identified, so it is still far from a standardized application protocol regarding the stimulation parameters for each disorder. It is necessary to conduct randomized controlled trials with large samples to reach definitive conclusions on these issues. Moreover, it is also essential to investigate the effects of treatment in the medium and long term, given the current lack of data in this regard.

Authors' methods: The following electronic databases were consulted: MEDLINE and PREMEDLINE (1950-October 2012), EMBASE (1980-October 2012), PsycINFO (1887-October 2012), CINAHL (1982-October 2012), Cochrane Library (1982-October 2012), Centre for Reviews & Dissemination (1973-October 2012). This search strategy was complemented by manual bibliographic. Two reviewers performed the entire selection process of studies and in case of doubt or disagreement between them a third reviewer was consulted, who revised the protocol criteria and tried to reach a consensus with the other two reviewers. We selected systematic reviews with meta-analysis of randomized controlled trials examining the efficacy of rTMS versus placebo (sham rTMS) or electroconvulsive therapy, for any medical conditions. The study selection was limited to those published in English and Spanish. The data extraction of the studies was carried out on specific sheet. The methodological quality of included reviews was assessed using the Oxman scale.

Project Status: Completed

Year Published: 2013

URL for published report: https://sescs.es/indicaciones-de-la-estimulacion-magnetica-transcraneal/

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Spain

Organisation Name: Canary Health Service

Contact Address: Dirección del Servicio. Servicio Canario de la Salud, Camino Candelaria 44, 1ª planta, 38109 El Rosario, Santa Cruz de Tenerife

Contact Name: sescs@sescs.es

Contact Email: sescs@sescs.es