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Repetitive Transcranial Magnetic Stimulation for Major Depressive Disorder in Older Adults: Systematic Review and Meta-analysis.
Valiengo, Leandro; Maia, Ana; Cotovio, Gonçalo; Gordon, Pedro C; Brunoni, André R; Forlenza, Orestes V; Oliveira-Maia, Albino J.
Afiliação
  • Valiengo L; Laboratório de Neurociências (LIM-27), Departamento e Instituto de Psiquiatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Brazil.
  • Maia A; Serviço Interdisciplinar de Neuromodulação (SIN), Departamento e Instituto de Psiquiatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Brazil.
  • Cotovio G; Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, Portugal.
  • Gordon PC; Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa Ocidental, Portugal.
  • Brunoni AR; Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, Portugal.
  • Forlenza OV; Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa Ocidental, Portugal.
  • Oliveira-Maia AJ; Serviço Interdisciplinar de Neuromodulação (SIN), Departamento e Instituto de Psiquiatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Brazil.
J Gerontol A Biol Sci Med Sci ; 77(4): 851-860, 2022 04 01.
Article em En | MEDLINE | ID: mdl-34432865
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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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transtorno Depressivo Maior / Estimulação Magnética Transcraniana Tipo de estudo: Clinical_trials / Etiology_studies / Prognostic_studies / Systematic_reviews Limite: Aged / Humans Idioma: En Revista: J Gerontol A Biol Sci Med Sci Assunto da revista: GERIATRIA Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transtorno Depressivo Maior / Estimulação Magnética Transcraniana Tipo de estudo: Clinical_trials / Etiology_studies / Prognostic_studies / Systematic_reviews Limite: Aged / Humans Idioma: En Revista: J Gerontol A Biol Sci Med Sci Assunto da revista: GERIATRIA Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos