TY - JOUR PY - 2023// TI - Growing placebo response in TMS treatment for depression: a meta-analysis of 27-year randomized sham-controlled trials JO - Nature mental health A1 - Xu, Yangting A1 - Zhang, Yuhan A1 - Zhao, Di A1 - Tian, Yanghua A1 - Yuan, Ti-Fei SP - ePub EP - ePub VL - ePub IS - ePub N2 - This meta-analysis investigated placebo responses in repetitive transcranial magnetic stimulation treatment for depression, an area with limited systematic analysis. The initial literature search yielded 2,783 relevant records from the past 27 years, leading to the analysis of 52 randomized controlled trials encompassing 54 placebo arms with 2,122 sham participants. Placebo responses were large (d = 1.016) and increasing yearly (Z = 2.18, P = 0.029), irrespective of sham methods, assessment scales or age. Nevertheless, the trial location, number of sites, sample size, sponsor, sex ratio, study quality and medication status had an influence on the active or sham effect and consequently the outcome. Notably, the placebo and active effects increased in parallel (rs = 0.738, P < 0.001), resulting in a time-independent trial outcome. These findings reveal significant placebo responses from 1996 to 2022 but with minimal impact on the trial outcomes, as placebo and active effects demonstrated parallel growth. These results could inform the design of further clinical trials, especially for repetitive transcranial magnetic stimulation in the treatment of depression.

Language: en

LA - en SN - 2731-6076 UR - http://dx.doi.org/10.1038/s44220-023-00118-9 ID - ref1 ER -