Comparing different non-invasive brain stimulation interventions for bipolar depression treatment: A network meta-analysis of randomized controlled trials

  • Chih Wei Hsu
  • , Po Han Chou
  • , Andre R. Brunoni
  • , Kuo Chuan Hung
  • , Ping Tao Tseng
  • , Chih Sung Liang
  • , Andre F. Carvalho
  • , Eduard Vieta
  • , Yu Kang Tu
  • , Pao Yen Lin
  • , Che Sheng Chu
  • , Tien Wei Hsu
  • , Yang Chieh Brian Chen*
  • , Cheng Ta Li*
  • *Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

17 Scopus citations

Abstract

Non-invasive brain stimulation (NIBS) is a promising treatment for bipolar depression. We systematically searched for randomized controlled trials on NIBS for treating bipolar depression (INPLASY No: 202340019). Eighteen articles (N = 617) were eligible for network meta-analysis. Effect sizes were reported as standardized mean differences (SMDs) or odds ratios (ORs) with 95% confidence intervals (CIs). Anodal transcranial direct current stimulation over F3 plus cathodal transcranial direct current stimulation over F4 (a-tDCS-F3 +c-tDCS-F4; SMD = −1.18, 95%CIs = −1.66 to −0.69, N = 77), high-definition tDCS over F3 (HD-tDCS-F3; −1.17, −2.00 to −0.35, 25), high frequency deep transcranial magnetic stimulation (HF-dTMS; −0.81, −1.62 to −0.001, 25), and high frequency repetitive TMS over F3 plus low frequency repetitive TMS over F4 (HF-rTMS-F3 +LF-rTMS-F4; −0.77, −1.43 to −0.11, 38) significantly improved depressive symptoms compared to sham controls. Only a-tDCS-F3 +c-tDCS-F4 (OR = 4.53, 95%CIs = 1.51–13.65) and HF-rTMS-F3 +LF-rTMS-F4 (4.69, 1.02–21.56) showed higher response rates. No active NIBS interventions exhibited significant differences in dropout or side effect rates, compared with sham controls.

Original languageEnglish
Article number105483
Pages (from-to)105483
JournalNeuroscience and Biobehavioral Reviews
Volume156
DOIs
StatePublished - 01 2024

Bibliographical note

Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.

Keywords

  • Antidepressant
  • Bipolar disorder
  • Theta burst stimulation
  • Transcranial electrical stimulation
  • Transcranial Magnetic Stimulation
  • Transcranial Direct Current Stimulation
  • Humans
  • Bipolar Disorder/therapy
  • Brain/physiology
  • Network Meta-Analysis
  • Randomized Controlled Trials as Topic

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