title: Repetitive transcranial magnetic stimulation for the treatment of depression. Systematic review and meta-analysis.
abstract: BACKGROUND
  Repetitive transcranial magnetic stimulation (rTMS) may be useful in the treatment of depression but results from trials have been inconclusive to date.
  
  
  OBJECTIVE
  To assess the efficacy of rTMS in treating depression.
  
  
  METHODS
  We conducted a systematic review of randomised controlled trials that compared rTMS with sham in patients with depression. We assessed the quality of design of all studies and conducted a meta-analysis of data from trials with similar rTMS delivery.
  
  
  RESULTS
  We included a total of 14 trials. The quality of the included studies was low. Pooled analysis using the Hamilton Rating Scale for Depression showed an effect in favour of rTMS compared with sham after 2 weeks of treatment (standardised mean difference=-0.35; 95% CI -0.66 to -0.04), but this was not significant at the 2-week follow-up (standardised mean difference=-0.33; 95% CI -0.84 to 0.17).
  
  
  CONCLUSIONS
  Current trials are of low quality and provide insufficient evidence to support the use of rTMS in the treatment of depression.
authors.affiliation: Iberoamerican Cochrane Centre, Hospital de la Santa Crue i Sant Pau, Barcelona, Spain. jrodriguezma@hsp.santpau.es
authors.forename: José Luis R
authors.initials: JL
authors.lastname: Martin
authors.forename: Manuel J
authors.initials: MJ
authors.lastname: Barbanoj
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Schlaepfer
authors.forename: Elinor
authors.initials: E
authors.lastname: Thompson
authors.forename: Víctor
authors.initials: V
authors.lastname: Pérez
authors.forename: Jaime
authors.initials: J
authors.lastname: Kulisevsky
mesh_terms: D000328:Adult; D003866:Depressive Disorder / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D016032:Randomized Controlled Trials as Topic / Q000592:standards; D013997:Time Factors; D050781:Transcranial Magnetic Stimulation / Q000627:therapeutic use*; D016896:Treatment Outcome