. 2021 May 6;21(4):1–232.

Table A6:

Change in Depression Scores for rTMS Modalities Versus Sham Treatment

Author, Year	No. of Studies (Sample Size)	Results	Conclusions
HF Left DLPFC
Lepping et al, 2014⁴²	10 (120)	MD 6.18 (SD 4.48, P = NR) I² = NR Favouring rTMS	“Our results confirm a statistical superiority of rTMS over sham rTMS in the treatment of TRD”
Health Quality Ontario, 2016¹⁸	15 (NR)	WMD 2.31 (95% CI 1.19–3.42, P < .001) I² = 19.8% Favouring rTMS SMD 0.33 (95% CI 0.17–0.5, P < .001) I² = 14.7%	“On average, rTMS reduced depression scores by about 2 points more than sham rTMS”
Sehatzadeh et al, 2019⁴¹	18 (NR)	WMD 3.36 (95% CI 1.85–4.88, P = .00) I² = 62.4% Favouring rTMS	“Our study suggests that rTMS has moderate antidepressant effects and appears to be promising in the short-term treatment of patients with unipolar TRD”
Bilateral rTMS
Sehatzadeh et al, 2019⁴¹	4 (NR)	WMD 2.67 (95% CI 0.83–4.51, P = .5) I² = 0% No difference	—
All TBS modalities^a
Berlim et al, 2017⁴⁵	6 (118 + 103)	Hedge's g = 1.0 (95% CI 0.3–1.7, P = .003) I² = 82% Favouring TBS Removal of two trials that contributed tolarge heterogeneity: Hedge's g = 0.5 (95% CI 0.1–0.8, P = .004) I² = 0% Favouring TBS	“Significant and large-sized different in outcome favouring the active procedure”
Deep TMS
Nordenskjold et al, 2016⁴⁴	1 (89 + 92)	Deep TMS −6.17 (−7.78 to −4.55) Sham deep TMS −3.94 (−5.58 to −2.29) P = .05 Favouring deep TMS	“Scientific support for deep TMS is considered insufficient for TRD”

Abbreviations: CI, confidence interval; cTBS, continuous theta burst stimulation; DLPFC, dorsolateral prefrontal cortex; HF, high frequency; iTBS, intermittent theta burst stimulation; MD, mean difference; NR, not reported; TMS, repetitive transcranial magnetic stimulation; SD, standard deviation; SMD, standardized mean difference; TBS, theta burst stimulation; TMS, transcranial magnetic stimulation; TRD, treatment-resistant depression; WMD, weighted mean difference.

Includes two unilateral cTBS, two unilateral iTBS, three bilateral TBS.