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Cited by 65Transcranial Magnetic Stimulation StudiesTreatment of Major DepressionElectroconvulsive Therapy Studies

Repetitive transcranial magnetic stimulation for major depressive disorder in older adults: systematic review and meta-analysis

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Valiengo, Leandro, Maia, Ana, Cotovio, Gonçalo, Gordon, Pedro C, Brunoni, André R, Forlenza, Orestes V, Oliveira-Maia, Albino J·2022·The Journals of Gerontology: Series A
DOI 10.1093/gerona/glab235
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Abstract

Background: Major depressive disorder (MDD) in older adults is a serious public health concern. Repetitive transcranial magnetic stimulation (rTMS) is a nonpharmacological intervention approved for MDD treatment in adults, but its value in older adults remains unknown. This study aims to systematically review and meta-analyze evidence of rTMS efficacy in MDD treatment among older adults. Methods: We systematically reviewed the literature for randomized controlled trials (RCTs) and open-label studies assessing rTMS for the treatment of MDD in patients older than 50 years, published until June 2020. Random-effects meta-analyses using standardized mean differences (SMDs) were conducted to assess change in depression severity score (primary outcome), while odds ratios (ORs) were used to assess secondary categorical outcomes (response and remission). Additionally, univariate meta-regression analyses were performed to identify potential predictors of change in depression severity scores. Results: Fourteen RCTs were included in meta-analyses and 26 studies (10 RCTs and 16 open-label studies) in meta-regression. Active rTMS was significantly superior to sham treatment for reduction of severity (SMD = 0.36; 95% CI = 0.13–0.60), as well as response (OR = 3.26; 95% CI = 2.11–5.04) and remission (OR = 4.63; 95% CI = 2.24–9.55). Studies were of moderate to high quality, with funnel plots and Egger’s regression test not suggestive of publication bias. In meta-regressions, higher mean age and number of sessions were significantly associated with greater improvement. Conclusions: Our results support that rTMS is an effective, safe, and well-tolerated treatment for MDD in older adults and that it should be considered in the treatment of this vulnerable population.

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Cited by

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Authors
Valiengo, L., Maia, A., Cotovio, G., Gordon, P. C., Brunoni, A. R., Forlenza, O. V., & Oliveira-Maia, A. J.
Affiliations
  • Universidade de São Paulo (BR)
  • Hospital de Egas Moniz (PT)
  • Centro Champalimaud (PT)
Corresponding author
Oliveira-Maia, Albino J
ORCID
Venue
The Journals of Gerontology: Series A
Publisher
Oxford University Press (OUP)
Published
2021-08-25
Volume
77
Issue
4
Pages
851-860
ISSN
  • 1079-5006 (ISSN-L)
  • 1758-535X
DOI
10.1093/gerona/glab235
OpenAlex
W3196029929
Cited by
65
References
10
Citations by year
2026: 11 · 2025: 16 · 2024: 16 · 2023: 13 · 2022: 7 · 2021: 2
FWCI
1.11
Type
journal article
Language
en
Open access
Licence
academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
Locations
  • The Journals of Gerontology Series A (publishedVersion)
  • PubMed (publishedVersion)
  • Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, other-oa)
Funders
  • Conselho Nacional de Desenvolvimento Científico e Tecnológico (466625/2014-6)
  • National Institute for Biomarker Research in Neuropsychiatry (14/50873-3, 2016/01302-9, 465412/2014-9)
  • Associação Beneficente Alzira Denise Hertzog da Silva
  • Fundação para a Ciência e Tecnologia (PTDC/MED-NEU/31331/2017, PTDC/MED-NEU/30302/2017)
  • MCTES
  • Fundo Europeu de Desenvolvimento Regional
  • Fundação de Amparo à Pesquisa do Estado de São Paulo (19/06009-6, 18/10861-7)
  • Newton Advanced Fellowship (NAFR12\1010)
Topics
  • Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
Keywords
repetitive transcranial magnetic stimulation, major depressive disorder, older adults, depression severity, treatment response and remission, predictors of treatment response
MeSH terms
Aged, Major Depressive Disorder, Humans, Research Design, Odds Ratio, Treatment Outcome, Transcranial Magnetic Stimulation

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