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Table 2 Patient characteristics at baseline and depression scores in the active rTMS and sham groups in N = 40 RCTs

From: Short-term efficacy of repetitive transcranial magnetic stimulation (rTMS) in depression- reanalysis of data from meta-analyses up to 2010

Study

Mean age (all patients)

Female (% all patients)

Treatment-resistanceA

Bipolar (%)B

Psychotic (%)C

MedicationD

Data source

ScaleE

Mean ± SD(number of patients) depression severity score

Baseline

Last sessionF

Baseline – last session

Sham

rTMS

Sham

rTMS

Sham

rTMS

George et al. ([1997])

42

92%

some

+ 8%

N/A

+

Tab one

HAMD21

26 ± 3 (5)

30 ± 4 (7)

30 ± 8 (5)

23 ± 9 (7)

-4 ± 7 (5)

7 ± 8 (7)

Avery et al. ([1999])

44

83%

+

+ 17%

-

+

Tab one

HAMD21

20 ± 8 (2)

21 ± 7 (4)

15 ± 2 (2)

11 ± 4 (4)

5 ± 7 (2)

10 ± 6 (4)

BDI21

20 ± 7 (2)

28 ± 7 (4)

14 ± 11 (2)

20 ± 11 (4)

6 ± 10 (2)

8 ± 10 (4)

Kimbrell et al. ([1999])

42

54%

N/A

+ 31%

N/A

-

All (Tab one)

HAMD21

24 ± 7 (3)

30 ± 8 (10)

25 ± 10 (3)

27 ± 10 (10)

-1 ± 9 (3)

3 ± 9 (10)

20Hz

24 ± 7 (3)

25 ± 7 (5)

25 ± 10 (3)

28 ± 8 (5)

-1 ± 9 (3)

-3 ± 8 (5)

1Hz

24 ± 7 (3)

34 ± 8 (5)

25 ± 10 (3)

27 ± 13 (5)

-1 ± 9 (3)

7 ± 11 (5)

Klein et al. ([1999])

59

76%

-

+ 19%

+ 23%

+

Tab two

HAMD17

25 ± 6 (32)

26 ± 6 (35)

20 ± 10 (32)

14 ± 9 (35)

5 ± 9 (32)

12 ± 8 (35)

MADRS

34 ± 8 (32)

34 ± 5 (35)

27 ± 12 (32)

20 ± 12 (35)

7 ± 11 (32)

14 ± 10 (35)

Loo et al. ([1999])

48

50%

some

+ 17%

+ 6%

+

Authors

HAMD21

25 ± 6 (9)

21 ± 7 (9)

19 ± 7 (9)

17 ± 7 (9)

6 ± 7 (9)

4 ± 7 (9)

MADRS

38 ± 6 (9)

33 ± 9 (9)

29 ± 10 (9)

26 ± 9 (9)

9 ± 9 (9)

7 ± 9 (9)

Padberg et al. ([1999])

51

61%

+

-

N/A

+

All

HAMD21

22 ± 9 (6)

28 ± 9 (12)

24 ± 10 (6)

25 ± 8 (12)

-2 ± 10 (6)

3 ± 8 (12)

Text 10Hz

22 ± 9 (6)

30 ± 10 (6)

24 ± 10 (6)

28 ± 9 (6)

-2 ± 10 (6)

2 ± 10 (6)

Fig one 0.3Hz

22 ± 9 (6)

27 ± 9 (6)

24 ± 10 (6)

22 ± 6 (6)

-2 ± 10 (6)

5 ± 8 (6)

Berman et al. ([2000])

42

30%

some

+ 5%

+ 5%

-

Tab one

HAMD25

37 ± 8 (10)

37 ± 10 (10)

36 ± 9 (10)

25 ± 9 (10)

1 ± 8 (10)

12 ± 10 (10)

Eschweiler et al. ([2000])

57

67%

N/A

-

+ 8%

+

Tab one

HAMD21

20 ± 4 (5)

27 ± 4 (7)

23 ± 6 (5)

22 ± 5 (7)

-3 ± 5 (5)

5 ± 5 (7)

BDI21

28 ± 10 (5)

40 ± 6 (7)

32 ± 9 (5)

33 ± 11 (7)

-4 ± 10 (5)

7 ± 10 (7)

George et al. ([2000])

44

63%

N/A

+ 30%

-

-

All (Tab one)

HAMD21

24 ± 4 (10)

28 ± 6 (20)

19 ± 6 (10)

18 ± 9 (20)

5 ± 5 (10)

10 ± 8 (20)

Garcia-Toro et al. ([2001a])

51

43%

+

-

N/A

+

Tab two

HAMD21

26 ± 5 (18)

27 ± 7 (17)

24 ± 4 (18)

20 ± 6 (17)

2 ± 5 (18)

7 ± 7 (17)

BDI17

26 ± 6 (18)

27 ± 9 (17)

24 ± 5 (18)

22 ± 7 (17)

2 ± 6 (18)

5 ± 8 (17)

Garcia-Toro et al. ([2001b])

44

55%

-

N/A

N/A

+D1

Tab one

HAMD21

27 ± 6 (11)

26 ± 6 (11)

18 ± 9 (11)

16 ± 8 (11)

9 ± 8 (11)

10 ± 7 (11)

BDI17

23 ± 7 (11)

27 ± 8 (11)

21 ± 8 (11)

19 ± 7 (11)

2 ± 8 (11)

8 ± 8 (11)

Manes et al. ([2001])

61

50%

some

N/A

N/A

-

Tab two

HAMD21

23 ± 7 (10)

23 ± 5 (10)

16 ± 8 (10)

14 ± 5 (10)

7 ± 8 (10)

9 ± 5 (10)

Boutros et al. ([2002])

51

22%

+

-

N/A

+

Tab two

HAMD25

36 ± 4 (7)

40 ± 10 (11)

26 ± 13 (7)

27 ± 13 (11)

10 ± 12 (7)

13 ± 12 (11)

Padberg et al. ([2002])

57

70%

+

N/A

N/A

+

All (Tab one, Fig two)

HAMD21

24 ± 6 (10)

24 ± 6 (10)

22 ± 6 (10)

17 ± 9 (10)

2 ± 6 (10)

7 ± 8 (10)

MADRS

30 ± 6 (10)

29 ± 6 (10)

29 ± 6 (10)

19 ± 9 (10)

1 ± 6 (10)

10 ± 8 (10)

Fitzgerald et al. ([2003])

46

43%

+

+ 10%

N/A

+

All

MADRS

36 ± 8 (20)

37 ± 8 (40)

35 ± 8 (20)

32 ± 8 (40)

1 ± 8 (20)

5 ± 8 (40)

BDI21

32 ± 9 (20)

34 ± 11 (40)

29 ± 9 (20)

27 ± 11 (40)

3 ± 9 (20)

7 ± 11 (40)

Tab two 10Hz

MADRS

36 ± 8 (20)

36 ± 8 (20)

35 ± 8 (20)

31 ± 8 (20)

1 ± 8 (20)

5 ± 8 (20)

BDI21

32 ± 9 (20)

33 ± 12 (20)

29 ± 9 (20)

27 ± 12 (20)

3 ± 9 (20)

6 ± 12 (20)

Tab two 1Hz

MADRS

36 ± 8 (20)

38 ± 8 (20)

35 ± 8 (20)

32 ± 9 (20)

1 ± 8 (20)

6 ± 8 (20)

BDI21

32 ± 9 (20)

35 ± 9 (20)

29 ± 9 (20)

27 ± 11 (20)

3 ± 9 (20)

8 ± 10 (20)

Höppner et al. ([2003])

59

70%

N/A

+ 3%

-

+

Fig two 20Hz

HAMD21

25 ± 8 (10)

22 ± 4 (10)

13 ± 8 (10)

14 ± 5 (10)

12 ± 8 (10)

8 ± 5 (10)

Fig one 20Hz

BDI21

28 ± 8 (10)

26 ± 7 (10)

22 ± 11 (10)

18 ± 8 (10)

6 ± 10 (10)

8 ± 8 (10)

Loo et al. ([2003])

52

79%

some

+ 16%

N/A

+

Authors

HAMD17

20 ± 4 (10)

24 ± 5 (9)

16 ± 7 (10)

19 ± 8 (9)

4 ± 6 (10)

5 ± 7 (9)

MADRS

33 ± 5 (10)

38 ± 6 (9)

27 ± 10 (10)

31 ± 14 (9)

6 ± 9 (10)

7 ± 12 (9)

Nahas et al. ([2003])

43

61%

N/A

+ 100%

N/A

-

Authors

HAMD28

33 ± 8 (12)

32 ± 4 (11)

24 ± 12 (12)

24 ± 12 (11)

9 ± 11 (12)

8 ± 11 (11)

Buchholtz et al. ([2004])

50

31%

N/A

+ 23%

N/A

+

Authors

HAMD17

24 ± 5 (7)

26 ± 3 (6)

13 ± 10 (7)

16 ± 3 (6)

11 ± 9 (7)

10 ± 3 (6)

Hausmann et al. ([2004])

47

61%

N/A

N/A

-

+D1

Tab two

HAMD21

34 ± 4 (13)

32 ± 6 (25)

22 ± 8 (13)

18 ± 9 (25)

12 ± 7 (13)

14 ± 8 (25)

BDI13

31 ± 12 (13)

32 ± 10 (25)

21 ± 14 (13)

17 ± 12 (25)

10 ± 13 (13)

15 ± 11 (25)

Holtzheimer et al. ([2004])

43

47%

+

-

-

-

Tab two

HAMD17

21 ± 6 (8)

23 ± 5 (7)

15 ± 3 (8)

15 ± 3 (7)

6 ± 5 (8)

8 ± 4 (7)

BDI21

28 ± 11 (8)

30 ± 10 (7)

22 ± 2 (8)

24 ± 3 (7)

6 ± 10 (8)

6 ± 9 (7)

Kauffmann et al. ([2004])

52

92%

+

N/A

N/A

+

Text

HAMD21

18 ± 5 (5)

22 ± 6 (7)

12 ± 4 (5)

11 ± 8 (7)

6 ± 4 (5)

11 ± 7 (7)

Koerselman et al. ([2004])

52

56%

N/A

N/A

N/A

+

Tab four

HAMD17

26 ± 6 (26)

26 ± 4 (26)

22 ± 7 (24)

21 ± 7 (25)

4 ± 7 (25)

5 ± 6 (26)

Mosimann et al. ([2004])

62

42%

+

+ 17%

N/A

+

Tab three

HAMD21

24 ± 7 (9)

28 ± 5 (15)

20 ± 7 (9)

23 ± 7 (15)

4 ± 7 (9)

5 ± 6 (15)

BDI21

28 ± 11 (9)

30 ± 9 (15)

23 ± 11 (9)

24 ± 13 (15)

5 ± 11 (9)

6 ± 12 (15)

Poulet et al. ([2004])

43

47%

N/A

N/A

N/A

+D1

Authors

MADRS

36 ± 7 (9)

33 ± 5 (10)

17 ± 9 (9)

16 ± 8 (10)

19 ± 8 (9)

17 ± 7 (10)

BDI13

18 ± 6 (9)

21 ± 8 (10)

11 ± 7 (9)

14 ± 7 (10)

7 ± 7 (9)

7 ± 8 (10)

Rossini et al. ([2005])a

47

80%

-

-

-

+D1

Tab two

HAMD21

    

8 ± 7 (47)

13 ± 7 (49)

Rumi et al. ([2005])

39

85%

N/A

N/A

-

+

Fig two

MADRS

39 ± 8 (24)

38 ± 8 (22)

28 ± 12 (24)

14 ± 11 (22)

11 ± 11 (24)

24 ± 10 (22)

Su et al. ([2005])

43

73%

+

+ 17%

-

+

All (Tab two)

HAMD21

23 ± 5 (10)

24 ± 7 (20)

19 ± 8 (10)

11 ± 7 (20)

4 ± 7 (10)

13 ± 7 (20)

BDI21

33 ± 10 (10)

31 ± 9 (20)

29 ± 15 (10)

16 ± 10 (20)

4 ± 13 (10)

15 ± 10 (20)

Avery et al. ([2006])

44

54%

+

-

-

+

Tab one, Text

HAMD17

24 ± 3 (33)

24 ± 4 (35)

20 ± 6 (33)

16 ± 8 (35)

4 ± 5 (33)

8 ± 7 (35)

BDI21

28 ± 8 (33)

28 ± 9 (35)

24 ± 8 (33)

17 ± 13 (35)

4 ± 8 (33)

11 ± 12 (35)

Fitzgerald et al. ([2006])

45

62%

+

+ 16%

-

+

Authors, Tab two

HAMD17

20 ± 5 (22)

23 ± 7 (25)

17 ± 6 (22)

16 ± 7 (25)

3 ± 6 (22)

7 ± 7 (25)

BDI21

29 ± 10 (22)

29 ± 10 (25)

22 ± 14 (22)

18 ± 10 (25)

7 ± 12 (22)

11 ± 10 (25)

MADRS

34 ± 6 (22)

34 ± 6 (25)

31 ± 8 (22)

26 ± 10 (25)

3 ± 7 (22)

8 ± 9 (25)

Garcia-Toro et al. ([2006])

48

55%

+

-

-

+

Tab two

HAMD21

25 ± 7 (10)

27 ± 5 (10)

24 ± 8 (10)

20 ± 8 (10)

1 ± 8 (10)

7 ± 7 (10)

Januel et al. ([2006])

38

78%

-

-

N/A

-

Tab one

HAMD17

22 ± 3 (16)

22 ± 4 (11)

17 ± 5 (16)

10 ± 6 (11)

5 ± 4 (16)

12 ± 5 (11)

Anderson et al. ([2007])

47

55%

some

N/A

N/A

+

Tab one

MADRS

28 ± 7 (14)

27 ± 4 (11)

23 ± 10 (14)

15 ± 10 (11)

5 ± 9 (14)

12 ± 9 (11)

Bortolomasi et al. ([2007])

56

58%

N/A

+ 16%

N/A

+

Fig two

HAMD24

22 ± 4 (7)

25 ± 8 (12)

18 ± 5 (7)

11 ± 10 (12)

4 ± 5 (7)

14 ± 9 (12)

Fig one

BDI21

27 ± 5 (7)

26 ± 7 (12)

22 ± 6 (7)

12 ± 10 (12)

5 ± 6 (7)

14 ± 9 (12)

Herwig et al. ([2007])

50

60%

some

+ 6%

N/A

+D1

Tab one

HAMD21

23 ± 5 (65)

25 ± 5 (62)

14 ± 8 (65)

14 ± 6 (62)

9 ± 7 (59)

11 ± 6 (57)

Tab two

BDI21

27 ± 10 (65)

27 ± 9 (62)

18 ± 10 (65)

16 ± 9 (62)

9 ± 10 (59)

11 ± 9 (57)

MADRS

27 ± 6 (65)

28 ± 7 (62)

16 ± 9 (65)

17 ± 8 (62)

11 ± 8 (59)

11 ± 8 (57)

Loo et al. ([2007])

48

47%

-

+ 11%

-

+

Tab two

HAMD17

21 ± 4 (19)

19 ± 4 (19)

15 ± 7 (19)

12 ± 6 (19)

6 ± 6 (19)

7 ± 5 (19)

BDI21

34 ± 8 (19)

27 ± 8 (19)

27 ± 10 (19)

18 ± 10 (19)

7 ± 9 (19)

9 ± 9 (19)

MADRS

33 ± 4 (19)

30 ± 4 (19)

27 ± 10 (19)

19 ± 8 (19)

6 ± 9 (19)

11 ± 7 (19)

O’Reardon et al. ([2007])

48

53%

some

-

-

-

Tab one

HAMD17

23 ± 4 (146)

23 ± 3 (155)

19 ± 6 (146)

17 ± 6 (155)

4 ± 5 (146)

6 ± 5 (155)

MADRS

34 ± 6 (146)

33 ± 6 (155)

30 ± 10 (146)

27 ± 11 (155)

4 ± 9 (146)

6 ± 10 (155)

Stern et al. ([2007])

53

-

some

-

-

-

All (Tab three)

HAMD21

27 ± 3 (15)

28 ± 4 (30)

27 ± 4 (14)

19 ± 8 (28)

0 ± 4 (14)

9 ± 7 (29)

10Hz

27 ± 3 (15)

28 ± 3 (10)

27 ± 4 (14)

15 ± 6 (10)

0 ± 4 (14)

13 ± 5 (10)

1Hz L

27 ± 3 (15)

28 ± 4 (10)

27 ± 4 (14)

28 ± 6 (8)

0 ± 4 (14)

0 ± 5 (9)

1Hz R

27 ± 3 (15)

28 ± 4 (10)

27 ± 4 (14)

16 ± 5 (10)

0 ± 4 (14)

12 ± 5 (10)

Bretlau et al. ([2008])

55

62%

some

N/A

-

+D1

Tab two

HAMD17

25 ± 3 (23)

25 ± 3 (22)

19 ± 5 (23)

16 ± 4 (22)

6 ± 4 (23)

9 ± 4 (22)

Mogg et al. ([2008])

54

63%

some

+ 2%

N/A

+

Authors

HAMD17

22 ± 5 (30)

21 ± 5 (29)

20 ± 8 (29)

16 ± 9 (28)

2 ± 7 (30)

5 ± 8 (28)

BDI-II21

36 ± 10 (30)

38 ± 11 (29)

31 ± 15 (26)

26 ± 15 (28)

5 ± 13 (28)

12 ± 14 (28)

  1. Notes: All studies included patients with a major depressive episode and/or disorder according to DSM-IV and/or ICD-10 criteria. The mean number of patients per group was used in the final calculations if patients dropped out throughout the study between baseline and final sessions. All values ending with exactly 0.5 were rounded as follows to reduce the rounding error: zero and uneven numbers upwards (1.5 = 2), even numbers downwards (2.5 = 2). Standard error of the mean (SEM) was converted to standard deviation (SD) using the formula: SD = SEM × √N (where N = sample size of sham or rTMS groups). ’All’ indicates that scores for all independent subgroups within studies were combined. AATreatment-resistance: + are studies in which all patients failed (or showed intolerance to) ≥2 antidepressant trials (of same or different class) of an adequate dose/length during current or lifetime episode; − are studies in which all patients failed ≤1 antidepressant trials; ‘some’ are studies in which patients failed ≥1 antidepressant trial (these studies were excluded from all analyses because this category overlapped with the + and – categories); BBipolar (%): + are studies including any proportion of patients with bipolar disorder at baseline; − means that all patients had unipolar depression (no history of bipolar disorder, mania, hypomania, Axis I disorders); CPsychotic (%): + are studies including any proportion of patients with psychotic features at baseline; − means that all patients had non-psychotic depression (no history of psychosis, Axis I disorders); DMedication = antidepressants (+means any proportion of patients/study received stable doses, +D1 means that antidepressants were started on day 1 concurrently with rTMS, − means that all patients were unmedicated but some might have received mood stabilizers); EIt was assumed that HAMD21 or BDI21 were used if no further information was provided.; F"Last session" refers to the last session of the double-blind phase of a study. aDepression scores were reported as change scores from baseline (baseline – final session). Abbreviations: BDI, Beck Depression Inventory; D1, antidepressants started on day 1 concurrently with rTMS; DLPFC, dorsolateral prefrontal cortex; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders; Fig, Figure; HAMD, Hamilton Depression Rating Scale; ICD-10, International Statistical Classification of Diseases and Related Health Problems; L, left DLPFC; MADRS, Montgomery Åsberg Depression Rating Scale; N/A, not reported or inadequate information; R, right DLPFC; RCT, randomised-controlled trial; rTMS, repetitive transcranial magnetic stimulation; SD, standard deviation; Tab, Table.