Accepted for/Published in: JMIR Research Protocols
Date Submitted: Dec 24, 2022
Open Peer Review Period: Dec 21, 2022 - Feb 15, 2023
Date Accepted: Apr 28, 2023
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Clinical Efficacy of Deep Transcranial Magnetic Stimulation (dTMS) in Psychiatric and Cognitive Disorders: A Systematic Review Protocol.
ABSTRACT
Background:
Deep transcranial magnetic stimulation (dTMS) is a novel non-invasive treatment option for psychiatric and cognitive disorders, including obsessive-compulsive disorder, substance use disorder, major depressive disorder (MDD), and Alzheimer’s Disease. With the use of Hesed-coil (H-coil) devices, dTMS can stimulate deeper regions of the brain compared to traditional repetitive transcranial magnetic stimulation (rTMS), resulting in more widespread effects.
Objective:
This review’s primary objective is to conduct a systematic review of the empirical literature on dTMS for psychiatric and cognitive disorders and, if feasible, a meta-analysis to compare the efficacy of active dTMS vs. sham/control for psychiatric disorders. Dementia, and related cognitive disorders, will also be examined. A secondary objective will be to examine subgroup differences (by age, sex, H-coil variety, and dTMS parameters [i.e., pulses per session, % motor threshold (%MT), session duration, number of sessions, etc.]) to evaluate whether dTMS differentially influences clinical outcomes based on these factors.
Methods:
A comprehensive search of the APA PsycINFO, Embase, Medline, and PubMed databases will be conducted using an appropriate search strategy. Two authors (A.D and M.D) will be responsible for screening relevant articles, assessing article eligibility (according to predetermined inclusion and exclusion criteria), and data extraction. Article eligibility discrepancies, if present, will be resolved by an independent third arbitrator (J.M.). All included articles will undergo a quality and risk of bias assessment. Data from included articles will be summarized qualitatively in a systematic review. If a sufficient number of equivalent studies are available, a meta-analysis will be performed to first (1) determine the effect of active vs. sham dTMS (or controls without a sham coil) stimulation across psychiatric and cognitive disorders, and second (2) examine subgroup effects of clinical outcomes.
Results:
N/A
Conclusions:
We will outline the evidence relating to the clinical efficacy of dTMS in various psychiatric and cognitive disorders. The results of this review will provide clinicians with valuable insight into the clinical (i.e., participant, age, sex, psychiatric or cognitive disorder, etc.) and methodological factors (i.e., H-coil design, dTMS parameters, etc.) which may contribute to dTMS efficacy, and thereby may assist clinicians in their decision to prescribe dTMS for specific psychiatric and cognitive disorders. Clinical Trial: PROSPERO Registration Number: CRD42022360066
Citation
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.