The effect of repetitive transcranial magnetic stimulation on sleep quality in patients with more than mild depressive mood: a systematic review and meta-analysis.

IF 3.2 3区医学 Q2 PSYCHIATRY Frontiers in Psychiatry Pub Date : 2025-02-06 eCollection Date: 2025-01-01 DOI:10.3389/fpsyt.2025.1511930

Yu'ang Liu, Silang Huang, Xinxin Zhang, Huangying Liao, Weiguo Liu, Zhi Zhang, Xianhui Qu, Ziwen Wang

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Abstract

Background: The purpose of this study was to systematically evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) therapy on sleep quality in patients with more than mild depressive mood.

Methods: Randomized controlled trials in PubMed, Cochrane Library, Web of Science, Embase, Scopus, and ScienceDirect on rTMS to improve sleep quality in patients with more than mild depressive mood up to September 2023 were searched. A meta-analysis was performed using RevMan 5.4 and Stata 17.0 software.

Results: A total of 11 studies, which involved 548 patients, were included. After rTMS treatment, the effect on sleep quality improvement in patients with more than mild depressive mood was better in the experimental group than in the control group [I ² = 53%, mean difference (MD) = -2.27, 95%CI = -2.97 to -1.57, p < 0.00001]. The results of the subgroup analyses showed that, in terms of stimulation frequency, compared with the 5-Hz and 10-Hz groups, the treatment effect of the 1-Hz group was better (I ² = 32%, MD = -2.69, 95%CI = -3.78 to -1.60, p < 0.00001). In terms of treatment duration, compared with the 2-week and 4-week groups, the group with more than 4 weeks of treatment had better treatment outcomes (I ² = 0%, MD = -2.81, 95%CI = -3.22 to -2.40, p < 0.00001). In terms of whether combination therapy was used or not, compared with the combination therapy group (I ² = 29%, MD = -1.39, 95%CI = -2.30 to -0.48, p = 0.003), the non-combination therapy group had a better treatment effect (I ² = 0%, MD = -2.93, 95%CI = -3.36 to -2.50, p < 0.00001).

Conclusion: rTMS significantly improves sleep quality in patients with more than mild depression. Subgroup analyses showed that the group using the 1-Hz stimulation frequency, the group with more than 4 weeks of treatment time, and the group with rTMS alone had better efficacy in treating the sleep quality of patients with more than mild depressive mood using rTMS, with the use of combination treatment or not being the main source of heterogeneity.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42023467971.

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重复经颅磁刺激对轻度以上抑郁情绪患者睡眠质量的影响：系统回顾和荟萃分析。

背景：本研究旨在系统评价重复经颅磁刺激（rTMS）治疗对轻度以上抑郁情绪患者睡眠质量的影响。方法：检索截至2023年9月PubMed、Cochrane Library、Web of Science、Embase、Scopus和ScienceDirect中有关rTMS改善轻度以上抑郁情绪患者睡眠质量的随机对照试验。采用RevMan 5.4和Stata 17.0软件进行meta分析。结果：共纳入11项研究，548例患者。rTMS治疗后，实验组对轻度以上抑郁情绪患者的睡眠质量改善效果优于对照组[I 2 = 53%, mean difference (MD) = -2.27, 95%CI = -2.97 ~ -1.57, p < 0.00001]。亚组分析结果显示，在刺激频率方面，与5 hz和10 hz组相比，1 hz组的治疗效果更好（I 2 = 32%, MD = -2.69, 95%CI = -3.78 ~ -1.60, p < 0.00001）。在治疗时间方面，与2周和4周组相比，治疗时间超过4周组治疗效果更好（I 2 = 0%, MD = -2.81, 95%CI = -3.22 ~ -2.40, p < 0.00001）。在是否使用联合治疗方面，与联合治疗组相比（I 2 = 29%, MD = -1.39, 95%CI = -2.30 ~ -0.48, p = 0.003），非联合治疗组的治疗效果更好（I 2 = 0%, MD = -2.93, 95%CI = -3.36 ~ -2.50, p < 0.00001）。结论：rTMS可显著改善轻度以上抑郁症患者的睡眠质量。亚组分析显示，刺激频率为1hz组、治疗时间超过4周组和单独rTMS组对轻度以上抑郁情绪患者的睡眠质量治疗效果较好，联合治疗或非异质性的主要来源。系统综述注册：https://www.crd.york.ac.uk/prospero/，标识符CRD42023467971。

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来源期刊

Frontiers in Psychiatry Medicine-Psychiatry and Mental Health

CiteScore

6.20

自引率

8.50%

发文量

2813

审稿时长

14 weeks

期刊介绍： Frontiers in Psychiatry publishes rigorously peer-reviewed research across a wide spectrum of translational, basic and clinical research. Field Chief Editor Stefan Borgwardt at the University of Basel is supported by an outstanding Editorial Board of international researchers. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. The journal''s mission is to use translational approaches to improve therapeutic options for mental illness and consequently to improve patient treatment outcomes.