May 22, 2024 | Michel Sabé, MD; Joshua Hyde, BSc; Catharina Cramer, MSc; Antonia-Leonie Eberhard, MSc; Alessio Crippa, PhD; André Russowsky Brunoni, PhD; André Aleman, PhD; Stefan Kaiser, MD; David S. Baldwin, MD; Matthew Garner, PhD; Othman Sentissi, PhD; Jess G. Fiederowicz, PhD; Valerie Brandt, PhD; Samuele Cortese, PhD; Marco Solmi, PhD
A systematic review and dose-response meta-analysis of 110 studies involving 4820 participants examined the effectiveness of transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) in treating various mental disorders. The study found significant dose-response associations for schizophrenia, depression, obsessive-compulsive disorder (OCD), and substance use disorders, with distinct curve shapes indicating different optimal doses for each condition. For schizophrenia, high-frequency TMS on the left dorsolateral prefrontal cortex (LD-LPFC) showed a bell-shaped curve, with the maximum effective dose at 21,695 total pulses. For depression, high-frequency TMS on the left DLPFC also showed a bell-shaped curve, with the maximum effective dose at 12,374 total pulses. For treatment-resistant depression, low-dose tDCS on the left DLPFC showed a bell-shaped curve, with the maximum effective dose at 48 coulombs. For OCD, low-frequency TMS on the right DLPFC showed an ascending curve, with the maximum effective dose at 19,117 total pulses. For posttraumatic stress disorder (PTSD), low-frequency TMS on the right DLPFC showed an ascending curve, with the maximum effective dose at 17,495 total pulses. For substance use disorders, low-dose tDCS on the left DLPFC showed a bell-shaped curve, with the maximum effective dose at 9.6 coulombs. The study also found that the optimal dose for each disorder and stimulation site varies, and that further research is needed to refine dose-response models for these treatments. The findings suggest that clinicians should consider these dose parameters when prescribing NIBS interventions to enhance symptom reduction in specific mental disorders.A systematic review and dose-response meta-analysis of 110 studies involving 4820 participants examined the effectiveness of transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) in treating various mental disorders. The study found significant dose-response associations for schizophrenia, depression, obsessive-compulsive disorder (OCD), and substance use disorders, with distinct curve shapes indicating different optimal doses for each condition. For schizophrenia, high-frequency TMS on the left dorsolateral prefrontal cortex (LD-LPFC) showed a bell-shaped curve, with the maximum effective dose at 21,695 total pulses. For depression, high-frequency TMS on the left DLPFC also showed a bell-shaped curve, with the maximum effective dose at 12,374 total pulses. For treatment-resistant depression, low-dose tDCS on the left DLPFC showed a bell-shaped curve, with the maximum effective dose at 48 coulombs. For OCD, low-frequency TMS on the right DLPFC showed an ascending curve, with the maximum effective dose at 19,117 total pulses. For posttraumatic stress disorder (PTSD), low-frequency TMS on the right DLPFC showed an ascending curve, with the maximum effective dose at 17,495 total pulses. For substance use disorders, low-dose tDCS on the left DLPFC showed a bell-shaped curve, with the maximum effective dose at 9.6 coulombs. The study also found that the optimal dose for each disorder and stimulation site varies, and that further research is needed to refine dose-response models for these treatments. The findings suggest that clinicians should consider these dose parameters when prescribing NIBS interventions to enhance symptom reduction in specific mental disorders.