Efficacy and safety of transcranial magnetic stimulation for anhedonia in patients with depressive disorder and schizophrenia:a Meta-analysis
Qin Weiqi
Li Ping
Wei Siyi
Li Shancong
Li Bo
Leng Jiahui
Abstract：Objective To summarize the efficacy and safety of transcranial magnetic stimulation(TMS)for anhedonia in patients with depressive disorder and schizophrenia and related influencing factors by meta-analysis.Methods The literature on TMS for anhedonia in patients with depressive disorder and schizophrenia was electronically searched in PubMed,Web of Science,Embase,PsycINFO,CINAHL,The Cochrane Library,China National Knowledge Infrastructure,China Biomedical Database,and WanFang Database.The search period was from database establishment to December 2024.Two researchers independently extracted data from the included literature and performed meta-analysis using RevMan 5.4.1 and Stata 16.0.Results A total of 18 papers with a total of 1 175 patients(782 with depressive disorder and 393 with schizophrenia)were included.Meta-analysis showed that TMS improved anhedonia in depressive disorder and schizophrenia with a statistically significant difference[SMD=0.55,95%CI(0.16,0.94),Z=2.74,P=0.006].Subgroup analysis showed that the efficacy in anhedonia using TMS in the left dorsolateral prefrontal cortex(DLPFC)was superior to that in other stimulation sites,and the difference was statistically significant[SMD=0.67,95%CI(0.21,1.13),Z=2.86,P=0.004].The efficacy of using high-frequency TMS greater than 1 Hz to intervene in anhedonia was superior to other stimulation frequencies,and the difference was statistically significant[SMD=0.53,95%CI(0.15,0.90),Z=2.74,P=0.006].The efficacy of the TMS intervention duration of≥4 weeks was superior to the other intervention durations,and the difference met the statistical threshold criterion[SMD=0.58,95%CI(0.01,1.16),Z=1.98,P=0.05].When assessed using the Negative Symptoms Scale,the improvement in anhedonia was better in intervention group than that in control group,and the difference was statistically significant[SMD=0.53,95%CI(0.24,0.83),Z=3.54,P=0.000 4].TMS had no significant adverse effects relative to other interventions[RR=0.83,95%CI(0.52,1.33),Z=0.78,P=0.44].Conclusions Long-duration,high-frequency and left DLPFC TMS can significantly improve anhedonia in patients with depressive disorder and schizophrenia without significant adverse effects.
Keywords：Depressive disorderSchizophreniaAnhedoniaTranscranial magnetic stimulationMeta-analysis
Publication Date：2025-09-20
Online Publishing Date：2025-09-23(First online date of this platform, not the publication date of the document)
Pages：9( 616-624 )