Repetitive transcranial magnetic stimulation for late-life depression: A systematic review and meta-analysis of randomized controlled trials.

ObjectiveRepetitive transcranial magnetic stimulation is considered a potential treatment of choice for late-life depression, but its efficacy remains unclear. Therefore, we conducted a systematic review and meta-analysis to investigate the efficacy of repetitive transcranial magnetic stimulation.MethodsWe systematically searched PubMed, Embase, Cochrane Library, and PsycINFO databases. Meta-analyses were performed to examine the improvement in depression measured by the Hamilton Depression Rating Scale score, response rate, and remission rate after repetitive transcranial magnetic stimulation treatment.ResultsA total of 10 trials were included. The pooled results revealed an improvement in the Hamilton Depression Rating Scale score (standardized mean difference:  0.51; 95% confidence interval: 0.33, 0.68), response rate (odds ratio: 2.62; 95% confidence interval: 1.37, 5.01), and remission rate (odds ratio: 6.88; 95% confidence interval: 2.93, 16.14). The pooled results of trials using repetitive transcranial magnetic stimulation with an intensity of ≥100% resting motor threshold revealed an improvement in the Hamilton Depression Rating Scale score (standardized mean difference:  3; 95% confidence interval: 1.87, 4.12) and response rate (odds ratio: 2.56; 95% confidence interval: 1.58, 4.13). No differences were observed in the pooled results of trials using repetitive transcranial magnetic stimulation with an intensity of <100% resting motor threshold.ConclusionRepetitive transcranial magnetic stimulation is effective in the treatment of late-life depression, especially with an intensity of ≥100% resting motor threshold. Future studies with larger sample sizes and long-term outcomes are still needed to provide more robust evidence. INPLASY202550075.