. 2014 May 7;10:727–756. doi: 10.2147/NDT.S58405

Table 5.

Random-effects subgroup analyses and meta-regressions of the change in depression scores (baseline – final) after rTMS compared to sham in N=54 sham-controlled studies published in 1997 – August 2013

Studies		N studies (%)^a		d (95% CI)		P_two–tailed
All studies (1997–2013)		54		−0.51 (−0.63, −0.39)		<0.001^*
Subgroups
Location-frequency^b		54
Left-slow (≤1 Hz)		4 (7%)		−0.61 (−1.21, −0.01)		0.046^*
Left-fast (>1 Hz)		43 (80%)		−0.49 (−0.63, −0.34)		<0.001^*
Right-slow		6 (11%)		−1.01 (−1.61, −0.42)		0.001^*
Right-fast		1 (2%)		0.03 (−0.86, 0.92)		0.948
Bilateral or sequential (left then right)		7 (13%)		−0.55 (−0.82, −0.29)		<0.001^*
Treatment resistance		27
Yes (all failed ≥2 AD trials)		21 (78%)		−0.52 (−0.70, −0.35)		<0.001^*
No (all failed 0–1 AD trials)		6 (22%)		−0.80 (−1.02, −0.50)		<0.001^*
Yes versus no^c						0.108
Concurrent medication		54
YES (any % of patients)		42 (78%)		−0.51 (−0.63, −0.38)		<0.001^*
Stable dose		35 (83%)		−0.51 (−0.65, −0.36)		<0.001^*
Started on day 1		7 (17%)		−0.50 (−0.77, −0.23)		<0.001^*
NO (all patients)		12 (22%)		−0.56 (−0.84, −0.28)		<0.001^*
YES versus NO^c						0.229
Bipolar depression		42
YES (any % of patients)		23 (55%)		−0.44 (−0.60, −0.28)		<0.001^*
NO (all patients)		19 (45%)		−0.54 (−0.72, −0.34)		<0.001^*
YES versus NO^c						0.921
Psychotic depression		28
YES (any % of patients)		5 (18%)		−0.51 (−1.14, 0.13)		0.117
NO (all patients)		23 (82%)		−0.58 (−0.77, −0.40)		<0.001^*
YES versus NO^c						0.745
Coil-type		51
F8		47 (92%)		−0.52 (−0.65, −0.38)		<0.001^*
Circular		4 (8%)		−0.62 (−1.05, −0.19)		0.005^*
F8 versus circular^c						0.561
Coil angle sham		54
0° (inactive coil)		5 (9%)		−0.36 (−0.64, −0.07)		0.015^*
0° (sham coil)		10 (19%)		−0.63 (−0.92, −0.34)		<0.001^*
45°		18 (33%)		−0.40 (−0.57, −0.22)		<0.001^*
90°		21 (39%)		−0.56 (−0.77, −0.35)		<0.001^*
0° (sham coil) versus 45°						0.757
0° (sham coil) versus 90°						0.150
	N studies	T²_total	T²_model	R²	B	P_two–tailed

Meta-regression predictors^d
% female patients	53	0.046	0.022	0.52	−0.01	0.002^*
Stimuli/session	33	0.043	0.004	0.91	0.0002	<0.001^*
Trains/session^e	48	0.071	0.044	0.38	0.007	0.013^*

Notes: Total patients in N=54 studies totaled N=2,242 (rTMS N=1,184, sham N=1,058).

The percent values are reported based on the number of studies that reported a particular characteristic;

effect sizes in subgroups based on location-frequency of rTMS were not compared statistically because some studies used multiple active rTMS groups but the same sham groups, and thus the subgroups were not independent;

subgroups were compared using the mixed-effect model; random-effects model was used to compute the overall mean weighted d in each subgroup and overall mean weighted d of subgroups were compared using the fixed-effect model because the number of subgroups was fixed;

proportion of the between-study variance in weighted d explained by the predictor was computed as R²=1 − (T²_model/T²_total), where T²_model is the between-study variance in the weighted d (outcome) unexplained by the regression model containing the predictor and T²_total is the within- and between-study variance;²⁹

following the Bonferroni correction for multiple regressions (new significance threshold of 0.05/7=0.007), the regression of trains/session on weighted d became non-significant.

P<0.05.

Abbreviations: AD, antidepressant; CI, confidence interval; rTMS, repetitive transcranial magnetic stimulation.