AUTHOR=Zheng Wei , Lan Xian-Jun , Qin Zhen-Juan , Yang Xin-Hu , Shi Zhan-Ming 

TITLE=Low-frequency repetitive transcranial magnetic stimulation for children and adolescents with first-episode and drug-naïve major depressive disorder: A systematic review

JOURNAL=Frontiers in Psychiatry

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2023.1111754

DOI=10.3389/fpsyt.2023.1111754

ISSN=1664-0640

ABSTRACT=<sec><title>Objective</title><p>This systematic review of randomized controlled trials (RCTs) was conducted to explore the therapeutic effects and safety of active low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) versus sham LF-rTMS in children and adolescent patients with first-episode and drug-naïve (FEDN) major depressive disorder (MDD).</p></sec><sec><title>Methods</title><p>A systematic literature search was performed, and data were extracted by two independent researchers. The coprimary outcomes were study-defined response and remission.</p></sec><sec><title>Results</title><p>A systematic search of the literature yielded 442 references, of which 3 RCTs (130 children and adolescents with FEDN MDD, 50.8% male, and mean age range from 14.5 to 17.5 years) met the inclusion criteria. Among the two RCTs (66.7%, 2/3) examining the effects of LF-rTMS on study-defined response and remission and cognitive function, active LF-rTMS was more efficacious than sham LF-rTMS in terms of study-defined response rate and cognitive function (all <italic>p</italic> &lt; 0.05) but not regarding study-defined remission rate (all <italic>p</italic> &gt; 0.05). No significant group differences were found with regard to adverse reactions. None of the included RCTs reported the dropout rate.</p></sec><sec><title>Conclusion</title><p>These findings preliminarily found that LF-rTMS could benefit children and adolescents with FEDN MDD in a relatively safe manner, although further studies are warranted.</p></sec>