Effects of Noninvasive Brain Stimulation Combined With Antidepressants in Patients With Poststroke Depression: A Systematic Review and Meta-Analysis
Objective: To evaluated the efficacy and safety of noninvasive brain stimulation (NIBS) combined with antidepressants in patients with poststroke depression (PSD).Methods: Seven databases were searched to identify randomized controlled trials of NIBS combined with antidepressants in the treatment of...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2022.887115/full |
| _version_ | 1818244975931949056 |
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| author | Jiabin Liang Jiabin Liang Jie Feng Jinhua He Yong Jiang Yong Jiang Haoyu Zhang Haoyu Zhang Hanwei Chen |
| author_facet | Jiabin Liang Jiabin Liang Jie Feng Jinhua He Yong Jiang Yong Jiang Haoyu Zhang Haoyu Zhang Hanwei Chen |
| author_sort | Jiabin Liang |
| collection | DOAJ |
| description | Objective: To evaluated the efficacy and safety of noninvasive brain stimulation (NIBS) combined with antidepressants in patients with poststroke depression (PSD).Methods: Seven databases were searched to identify randomized controlled trials of NIBS combined with antidepressants in the treatment of PSD based on the international classification of diseases (ICD-10) criteria and exclusion criteria. The retrieval time was from the database establishment to 31 October 2021. Two researchers independently screened the identified studies through the search strategy, extracted their characteristics, and evaluated the quality of the included literature. Cochrane Collaboration’s tool was used to assess risk of bias. RevMan 5.3 software was applied for meta-analysis.Results: A total of 34 randomized controlled trials were included, involving 2,711 patients with PSD. Meta-analysis showed that the total effective rate was higher in the combined therapy than the antidepressant alone [odds ratio (OR): 4.33; 95% confidence interval (CI): 3.07 to 6.11; p < 0.00001]. The Hamilton depressive scale (HAMD) score was significantly lower in repeated transcranial magnetic stimulation (rTMS) (≤10 Hz) combined with antidepressant than in antidepressant alone [standard mean difference (SMD): −1.44; 95% CI: −1.86 to −1.03; p < 0.00001]. No significant difference was seen in rTMS (>10 Hz) combined with antidepressant versus antidepressant alone (SMD: −4.02; 95% CI: −10.43 to 2.39; p = 0.22). In addition, combination therapy more strongly improved the modified Barthel index (MBI) scale than antidepressants [mean difference (MD): 8.29; 95% CI: 5.23–11.35; p < 0.00001]. Adverse effects were not significantly different between two therapies (OR: 1.33; 95% CI: 0.87 to 2.04; p = 0.18).Conclusion: Low-frequency rTMS (≤10 Hz) combined with antidepressants tends to be more effective than antidepressants alone in patients with PSD, and there are no significant adverse effects. In addition, combined therapy may enhance quality of life after stroke. Combination therapy with high-frequency rTMS (>10 Hz) showed no advantage in treating PSD. The transcranial electrical stimulation (TES) combined with antidepressants might be more effective than antidepressants alone, which are needed to confirm by more clinical trials since the. |
| first_indexed | 2024-12-12T14:25:34Z |
| format | Article |
| id | doaj.art-7a4600211fd04d15a4d204f183e4f08d |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-12-12T14:25:34Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Pharmacology |
| spelling | doaj.art-7a4600211fd04d15a4d204f183e4f08d2022-12-22T00:21:42ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122022-05-011310.3389/fphar.2022.887115887115Effects of Noninvasive Brain Stimulation Combined With Antidepressants in Patients With Poststroke Depression: A Systematic Review and Meta-AnalysisJiabin Liang0Jiabin Liang1Jie Feng2Jinhua He3Yong Jiang4Yong Jiang5Haoyu Zhang6Haoyu Zhang7Hanwei Chen8Central Laboratory, Guangzhou Panyu Central Hospital, Guangzhou, ChinaGraduate School, Guangzhou University of Chinese Medicine, Guangzhou, ChinaRadiology Department, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, ChinaCentral Laboratory, Guangzhou Panyu Central Hospital, Guangzhou, ChinaCentral Laboratory, Guangzhou Panyu Central Hospital, Guangzhou, ChinaGraduate School, Guangzhou University of Chinese Medicine, Guangzhou, ChinaCentral Laboratory, Guangzhou Panyu Central Hospital, Guangzhou, ChinaGraduate School, Guangzhou University of Chinese Medicine, Guangzhou, ChinaCentral Laboratory, Guangzhou Panyu Central Hospital, Guangzhou, ChinaObjective: To evaluated the efficacy and safety of noninvasive brain stimulation (NIBS) combined with antidepressants in patients with poststroke depression (PSD).Methods: Seven databases were searched to identify randomized controlled trials of NIBS combined with antidepressants in the treatment of PSD based on the international classification of diseases (ICD-10) criteria and exclusion criteria. The retrieval time was from the database establishment to 31 October 2021. Two researchers independently screened the identified studies through the search strategy, extracted their characteristics, and evaluated the quality of the included literature. Cochrane Collaboration’s tool was used to assess risk of bias. RevMan 5.3 software was applied for meta-analysis.Results: A total of 34 randomized controlled trials were included, involving 2,711 patients with PSD. Meta-analysis showed that the total effective rate was higher in the combined therapy than the antidepressant alone [odds ratio (OR): 4.33; 95% confidence interval (CI): 3.07 to 6.11; p < 0.00001]. The Hamilton depressive scale (HAMD) score was significantly lower in repeated transcranial magnetic stimulation (rTMS) (≤10 Hz) combined with antidepressant than in antidepressant alone [standard mean difference (SMD): −1.44; 95% CI: −1.86 to −1.03; p < 0.00001]. No significant difference was seen in rTMS (>10 Hz) combined with antidepressant versus antidepressant alone (SMD: −4.02; 95% CI: −10.43 to 2.39; p = 0.22). In addition, combination therapy more strongly improved the modified Barthel index (MBI) scale than antidepressants [mean difference (MD): 8.29; 95% CI: 5.23–11.35; p < 0.00001]. Adverse effects were not significantly different between two therapies (OR: 1.33; 95% CI: 0.87 to 2.04; p = 0.18).Conclusion: Low-frequency rTMS (≤10 Hz) combined with antidepressants tends to be more effective than antidepressants alone in patients with PSD, and there are no significant adverse effects. In addition, combined therapy may enhance quality of life after stroke. Combination therapy with high-frequency rTMS (>10 Hz) showed no advantage in treating PSD. The transcranial electrical stimulation (TES) combined with antidepressants might be more effective than antidepressants alone, which are needed to confirm by more clinical trials since the.https://www.frontiersin.org/articles/10.3389/fphar.2022.887115/fullnoninvasive brain stimulationpoststroke depressionrepeated transcranial magnetic stimulationantidepressantdepression |
| spellingShingle | Jiabin Liang Jiabin Liang Jie Feng Jinhua He Yong Jiang Yong Jiang Haoyu Zhang Haoyu Zhang Hanwei Chen Effects of Noninvasive Brain Stimulation Combined With Antidepressants in Patients With Poststroke Depression: A Systematic Review and Meta-Analysis Frontiers in Pharmacology noninvasive brain stimulation poststroke depression repeated transcranial magnetic stimulation antidepressant depression |
| title | Effects of Noninvasive Brain Stimulation Combined With Antidepressants in Patients With Poststroke Depression: A Systematic Review and Meta-Analysis |
| title_full | Effects of Noninvasive Brain Stimulation Combined With Antidepressants in Patients With Poststroke Depression: A Systematic Review and Meta-Analysis |
| title_fullStr | Effects of Noninvasive Brain Stimulation Combined With Antidepressants in Patients With Poststroke Depression: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Effects of Noninvasive Brain Stimulation Combined With Antidepressants in Patients With Poststroke Depression: A Systematic Review and Meta-Analysis |
| title_short | Effects of Noninvasive Brain Stimulation Combined With Antidepressants in Patients With Poststroke Depression: A Systematic Review and Meta-Analysis |
| title_sort | effects of noninvasive brain stimulation combined with antidepressants in patients with poststroke depression a systematic review and meta analysis |
| topic | noninvasive brain stimulation poststroke depression repeated transcranial magnetic stimulation antidepressant depression |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2022.887115/full |
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