A Critical Review and Synthesis of Clinical and Neurocognitive Effects of Noninvasive Neuromodulation Antidepressant Therapies.

2019 · Mixed · Insufficient evidence

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MixedInsufficient evidencePaper 1609

Study snapshot

Publicationmanual · 2019

Study typereview

Reported directionMixed

Evidence ratingInsufficient

Abstract

A Critical Review and Synthesis of Clinical and Neurocognitive Effects of Noninvasive Neuromodulation Antidepressant Therapies. McClintock SM, Kallioniemi E, Martin DM, Kim JU, Weisenbach SL, Abbott CC. A Critical Review and Synthesis of Clinical and Neurocognitive Effects of Noninvasive Neuromodulation Antidepressant Therapies. Focus (Am Psychiatr Publ). 2019 Jan;17(1):18-29. doi: 10.1176/appi.focus.20180031. Abstract There is a plethora of current and emerging antidepressant therapies in the psychiatric armamentarium for the treatment of major depressive disorder. Noninvasive neuromodulation therapies are one such therapeutic category; they typically involve the transcranial application of electrical or magnetic stimulation to modulate cortical and subcortical brain activity. Although electroconvulsive therapy (ECT) has been used since the 1930s, with the prevalence of major depressive disorder and treatment-resistant depression (TRD), the past three decades have seen a proliferation of noninvasive neuromodulation antidepressant therapeutic development. The purpose of this critical review was to synthesize information regarding the clinical effects, neurocognitive effects, and possible mechanisms of action of noninvasive neuromodulation therapies, including ECT, transcranial magnetic stimulation, magnetic seizure therapy, and transcranial direct current stimulation. Considerable research has provided substantial information regarding their antidepressant and neurocognitive effects, but their mechanisms of action remain unknown. Although the four therapies vary in how they modulate neurocircuitry and their resultant antidepressant and neurocognitive effects, they are nonetheless useful for patients with acute and chronic major depressive disorder and TRD. Continued research is warranted to inform dosimetry, algorithm for administration, and integration among the noninvasive neuromodulation therapies and with other antidepressant strategies to continue to maximize their safety and antidepressant benefit. Open access paper: ncbi.nlm.nih.gov

Machine Enhanced Logic

AI evidence extraction

Structured fields below were generated from the paper’s abstract and metadata to make the evidence easier to inspect. Automated extraction may be incomplete or incorrect; verify important details against the original paper.

Study typereview

Effect directionmixed

Populationpatients with major depressive disorder, including treatment-resistant depression

Sample sizeNot supplied

ExposureNot supplied

Evidence strengthInsufficientConfidence: 66% · Peer reviewed: yes

Main findings

This critical review synthesizes evidence on clinical antidepressant effects, neurocognitive effects, and possible mechanisms of action of ECT, transcranial magnetic stimulation, magnetic seizure therapy, and transcranial direct current stimulation. It states that considerable research has provided substantial information on antidepressant and neurocognitive effects, while mechanisms of action remain unknown, and that these therapies are useful for acute and chronic major depressive disorder and treatment-resistant depression.

Outcomes measured

antidepressant (clinical) effects
neurocognitive effects
mechanisms of action
safety/dosimetry considerations

Limitations

Mechanisms of action described as unknown in the abstract
No quantitative effect sizes or study selection details provided in the abstract

View raw extracted JSON

{
  "study_type": "review",
  "exposure": {
    "band": null,
    "source": "noninvasive neuromodulation therapies (ECT, transcranial magnetic stimulation, magnetic seizure therapy, transcranial direct current stimulation)",
    "frequency_mhz": null,
    "sar_wkg": null,
    "duration": null
  },
  "population": "patients with major depressive disorder, including treatment-resistant depression",
  "sample_size": null,
  "outcomes": [
    "antidepressant (clinical) effects",
    "neurocognitive effects",
    "mechanisms of action",
    "safety/dosimetry considerations"
  ],
  "main_findings": "This critical review synthesizes evidence on clinical antidepressant effects, neurocognitive effects, and possible mechanisms of action of ECT, transcranial magnetic stimulation, magnetic seizure therapy, and transcranial direct current stimulation. It states that considerable research has provided substantial information on antidepressant and neurocognitive effects, while mechanisms of action remain unknown, and that these therapies are useful for acute and chronic major depressive disorder and treatment-resistant depression.",
  "effect_direction": "mixed",
  "limitations": [
    "Mechanisms of action described as unknown in the abstract",
    "No quantitative effect sizes or study selection details provided in the abstract"
  ],
  "evidence_strength": "insufficient",
  "confidence": 0.66,
  "peer_reviewed_likely": "yes",
  "keywords": [
    "major depressive disorder",
    "treatment-resistant depression",
    "electroconvulsive therapy",
    "transcranial magnetic stimulation",
    "magnetic seizure therapy",
    "transcranial direct current stimulation",
    "noninvasive neuromodulation",
    "neurocognitive effects"
  ],
  "suggested_hubs": []
}

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AI-extracted fields are generated from the abstract and metadata and may be incomplete or incorrect. This material is for informational purposes and is not medical advice.

Identifiers and source

DOI: 10.1176/appi.focus.20180031
PubMed: Not supplied

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