Effectiveness of repetitive transcranial magnetic stimulation combined with antidepressants on post-stroke depression: A meta-analysis

Objective:To evaluate the efficacy of repeated transcranial magnetic stimulation (rTMS) combined with antidepressant in patients with poststroke depression (PSD).Methods:Scientific databases including PubMed,Cochrane library,OVID,China National Knowledge Infrastructure (CNKI),chinese biomedical database,(CBM),Wanfang Data,Chinese science and technology data (VIP) were searched,Only randomized controlled studies were included.Selected studies data were analyzed using RevMan5.3 and random effects model,Statistical process selection weighted mean difference (WMD) method,Comparisons were conducted to confirm whether there were significant differences in two groups.Results:Thirteen studies including 1033 subjects were analyzed.The literatures were divided into low frequency and high frequency subgroups.The Hamilton Rating Scale for Depression (HAMD) scores were significantly lower in the low frequency (WMD ＝-4.24,95％ CI:-6.57--1.92) and high frequency (WMD ＝-4.00,95％ CI:-4.56--3.65) intervention groups than in the control group.The scores of National Institutes of Health Stroke Scale (NIHSS) (WMD ＝-2.21,95％ CI:-3.04--1.38),Mini Mental State Examination (MMSE) (WMD ＝-7.00,95％ CI:-7.64--6.36),and the Barthel index or the Modified Barthel index (BI or MBI) were significantly higher in the intervention group than in the control group.Conclusion:It suggests that RTMS combined with antidepressants could significantly improve depressive symptoms,more conducive to the recovery of neurological function in patients,improving cognition and the quality of life of patients.