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(Reference retrieved automatically from SciELO through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Appraising the effectiveness of electrical and magnetic brain stimulation techniques in acute major depressive episodes: an umbrella review of meta-analyses of randomized controlled trials

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Author(s):
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Laís B. Razza [1] ; Leonardo Afonso dos Santos [2] ; Lucas Borrione [3] ; Helena Bellini ; Luis C. Branco [5] ; Eric Cretaz [6] ; Dante Duarte ; Ygor Ferrão [8] ; Ricardo Galhardoni ; João Quevedo ; Marcel Simis [11] ; Felipe Fregni [12] ; Christoph U. Correll ; Frank Padberg [14] ; Alisson Trevizol ; Zafiris J. Daskalakis ; Andre F. Carvalho ; Marco Solmi [18] ; André R. Brunoni
Total Authors: 19
Affiliation:
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[1] Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP). Laboratório de Neurociências (LIM27). Serviço Interdisciplinar de Neuromodulação - Brasil
[2] Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP). Laboratório de Neurociências (LIM27). Serviço Interdisciplinar de Neuromodulação - Brasil
[3] Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP). Laboratório de Neurociências (LIM27). Serviço Interdisciplinar de Neuromodulação - Brasil
[5] Spaulding Rehabilitation Hospital, Harvard Medical School. Neuromodulation and Clinical Research Center - Estados Unidos
[6] Departamento e Instituto de Psiquiatria, HCFMUSP. Serviço de Eletroconvulsoterapia - Brasil
[8] Departamento de Clínica Médica, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) - Brasil
[11] Instituto de Medicina Física e Reabilitação, HCFMUSP - Brasil
[12] Spaulding Rehabilitation Hospital, Harvard Medical School. Laboratory of Neuromodulation & Center for Clinical Research Learning, Department of Physical Medicine and Rehabilitation - Estados Unidos
[14] Ludwig Maximilian University Munich. Department of Psychiatry and Psychotherapy - Alemanha
[18] Università Degli Studi Di Padova. Dipartimento di Neuroscienze - Itália
Total Affiliations: 19
Document type: Journal article
Source: Revista Brasileira de Psiquiatria; v. 43, n. 5, p. 514-524, 2020-10-23.
Abstract

Electrical and magnetic brain stimulation techniques present distinct mechanisms and efficacy in the acute treatment of depression. This was an umbrella review of meta-analyses of randomized controlled trials of brain stimulation techniques for managing acute major depressive episodes. A systematic review was performed in the PubMed/MEDLINE databases from inception until March 2020. We included the English language meta-analysis with the most randomized controlled trials on the effects of any brain stimulation technique vs. control in adults with an acute depressive episode. Continuous and dichotomous outcomes were assessed. A Measurement Tool to Assess Systematic Reviews-2 was applied and the credibility of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation framework. Seven meta-analyses were included (5,615 patients), providing evidence for different modalities of brain stimulation techniques. Three meta-analyses were evaluated as having high methodological quality, three as moderate, and one as low. The highest quality of evidence was found for high frequency-repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation, and bilateral rTMS. There is strong clinical research evidence to guide future clinical use of some techniques. Our results confirm the heterogeneity of the effects across these techniques, indicating that different mechanisms of action lead to different efficacy profiles. (AU)

FAPESP's process: 19/07256-7 - Cerebral alteration perfusion induced by transcranial stimulation of the prefrontal cortex: a randomized, placebo-controlled study, using 99mTc SPECT
Grantee:Lais Boralli Razza
Support Opportunities: Scholarships in Brazil - Doctorate (Direct)