Comparing the efficacies of transcranial magnetic stimulation treatments using different targeting methods in major depressive disorder: protocol for a network meta-analysis

Introduction Transcranial magnetic stimulation (TMS) over the left dorsolateral prefrontal cortex (lDLPFC) has been widely used as a treatment for major depressive disorder (MDD) in the past two decades. Different methods for localising the lDLPFC target include the ‘5 cm’ method, the F3 method and...

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Main Authors: Hui Li, Jijun Wang, Huiru Cui, Lihua Xu, Yingying Tang, Jingjing Huang, Junjie Wang, Zhenying Qian, Sirui Wang, Gai Kong, Guanfu Wu, Yumei Wei
Format: Article
Language:English
Published: BMJ Publishing Group 2023-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/13/12/e075525.full
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author Hui Li
Jijun Wang
Huiru Cui
Lihua Xu
Yingying Tang
Jingjing Huang
Junjie Wang
Zhenying Qian
Sirui Wang
Gai Kong
Guanfu Wu
Yumei Wei
author_facet Hui Li
Jijun Wang
Huiru Cui
Lihua Xu
Yingying Tang
Jingjing Huang
Junjie Wang
Zhenying Qian
Sirui Wang
Gai Kong
Guanfu Wu
Yumei Wei
author_sort Hui Li
collection DOAJ
description Introduction Transcranial magnetic stimulation (TMS) over the left dorsolateral prefrontal cortex (lDLPFC) has been widely used as a treatment for major depressive disorder (MDD) in the past two decades. Different methods for localising the lDLPFC target include the ‘5 cm’ method, the F3 method and the neuro-navigational method. However, whether TMS efficacies differ between the three targeting methods remains unclear. We present a protocol for a systematic review and network meta-analysis (NMA) to compare the efficacies of TMS treatments using these three targeting methods in MDD.Methods and analysis Relevant studies reported in English or Chinese and published up to May 2023 will be identified from searches of the following databases: PubMed, Cochrane Central Register of Controlled Trials, Embase, PsycINFO, China National Knowledge Infrastructure, Wan Fang Database, Chinese BioMedical Literature Database, and China Science and Technology Journal Database. We will include all randomised controlled trials assessing the efficacy of an active TMS treatment using any one of the three targeting methods compared with sham TMS treatment or comparing efficacies between active TMS treatments using different targeting methods. Interventions must include a minimum of 10 sessions of high-frequency TMS over the lDLPFC. The primary outcome is the reduction score of the 17-item Hamilton Depression Rating Scale, 24-item Hamilton Depression Rating Scale or Montgomery-Asberg Depression Rating Scale. The dropout rate is a secondary outcome representing the TMS treatment’s acceptability. Pairwise meta-analyses and a random-effects NMA will be conducted using Stata. We will use the surface under the cumulative ranking curve to rank the different targeting methods in terms of efficacy and acceptability.Ethics and dissemination This systematic review and NMA does not require ethics approval. The results will be submitted for publication in a peer-reviewed journal.PROSPERO registration number CRD42023410273.
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spelling doaj-art-b4ead04a795a45329e9e6291dda274e22025-08-20T03:11:58ZengBMJ Publishing GroupBMJ Open2044-60552023-12-01131210.1136/bmjopen-2023-075525Comparing the efficacies of transcranial magnetic stimulation treatments using different targeting methods in major depressive disorder: protocol for a network meta-analysisHui Li0Jijun Wang1Huiru Cui2Lihua Xu3Yingying Tang4Jingjing Huang5Junjie Wang6Zhenying Qian7Sirui Wang8Gai Kong9Guanfu Wu10Yumei Wei111 Department of Liver Surgery & Transplantation, Liver Cancer Institute, Zhongshan Hospital Fudan University, Shanghai, China4 Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, Shanghai, ChinaShanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaprofessorState Key Laboratory of Systems Medicine for Cancer, Stem Cell Research Center, Ren Ji Hospital, Shanghai Cancer Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, ChinaSuzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, ChinaShanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaShanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaShanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaShanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaShanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaIntroduction Transcranial magnetic stimulation (TMS) over the left dorsolateral prefrontal cortex (lDLPFC) has been widely used as a treatment for major depressive disorder (MDD) in the past two decades. Different methods for localising the lDLPFC target include the ‘5 cm’ method, the F3 method and the neuro-navigational method. However, whether TMS efficacies differ between the three targeting methods remains unclear. We present a protocol for a systematic review and network meta-analysis (NMA) to compare the efficacies of TMS treatments using these three targeting methods in MDD.Methods and analysis Relevant studies reported in English or Chinese and published up to May 2023 will be identified from searches of the following databases: PubMed, Cochrane Central Register of Controlled Trials, Embase, PsycINFO, China National Knowledge Infrastructure, Wan Fang Database, Chinese BioMedical Literature Database, and China Science and Technology Journal Database. We will include all randomised controlled trials assessing the efficacy of an active TMS treatment using any one of the three targeting methods compared with sham TMS treatment or comparing efficacies between active TMS treatments using different targeting methods. Interventions must include a minimum of 10 sessions of high-frequency TMS over the lDLPFC. The primary outcome is the reduction score of the 17-item Hamilton Depression Rating Scale, 24-item Hamilton Depression Rating Scale or Montgomery-Asberg Depression Rating Scale. The dropout rate is a secondary outcome representing the TMS treatment’s acceptability. Pairwise meta-analyses and a random-effects NMA will be conducted using Stata. We will use the surface under the cumulative ranking curve to rank the different targeting methods in terms of efficacy and acceptability.Ethics and dissemination This systematic review and NMA does not require ethics approval. The results will be submitted for publication in a peer-reviewed journal.PROSPERO registration number CRD42023410273.https://bmjopen.bmj.com/content/13/12/e075525.full
spellingShingle Hui Li
Jijun Wang
Huiru Cui
Lihua Xu
Yingying Tang
Jingjing Huang
Junjie Wang
Zhenying Qian
Sirui Wang
Gai Kong
Guanfu Wu
Yumei Wei
Comparing the efficacies of transcranial magnetic stimulation treatments using different targeting methods in major depressive disorder: protocol for a network meta-analysis
BMJ Open
title Comparing the efficacies of transcranial magnetic stimulation treatments using different targeting methods in major depressive disorder: protocol for a network meta-analysis
title_full Comparing the efficacies of transcranial magnetic stimulation treatments using different targeting methods in major depressive disorder: protocol for a network meta-analysis
title_fullStr Comparing the efficacies of transcranial magnetic stimulation treatments using different targeting methods in major depressive disorder: protocol for a network meta-analysis
title_full_unstemmed Comparing the efficacies of transcranial magnetic stimulation treatments using different targeting methods in major depressive disorder: protocol for a network meta-analysis
title_short Comparing the efficacies of transcranial magnetic stimulation treatments using different targeting methods in major depressive disorder: protocol for a network meta-analysis
title_sort comparing the efficacies of transcranial magnetic stimulation treatments using different targeting methods in major depressive disorder protocol for a network meta analysis
url https://bmjopen.bmj.com/content/13/12/e075525.full
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