Non-invasive neuromodulation treatment for depression in adolescents: A systematic review and meta-analysis

Background: Synthesized evidence regarding the effectiveness of non-invasive neuromodulation treatment for adolescents remains scarce. This study aimed to perform the first meta-analysis of the impact of neuromodulation treatment on depressive symptoms in adolescents.

Methods: According to the PRISMA guidelines, a comprehensive review covering databases in English and Chinese from their inception to November 30, 2023, was conducted. Data were pooled to compute the standardized mean difference (SMD) and risk ratio (RR), along with their respective 95 % confidence intervals (CI).

Results: A total of 27 studies involving 2075 participants were included and examined. Noninvasive neuromodulation treatment demonstrated significant positive effects on depression symptoms compared with controlled conditions (Hamilton Depression Scale (HAMD) 17: SMD = 3.503, 95 % CI = 2.404-4.602, p < 0.001; HAMD 24: SMD = 3.375, 95 % CI = 2.437-4.314, p < 0.001). High heterogeneity was observed (I² = 95.2 % and 97.2 %, p < 0.01), along with a substantial risk of publication bias (p < 0.05). In terms of the treatment response, the RR reached 1.39 (95 % CI = 1.29-1.50, p < 0.001), with low heterogeneity (I² = 35 %, p = 0.07).

Conclusions: Noninvasive neuromodulation treatment significant alleviated depressive symptoms in adolescents. Future research should prioritize conducting high-quality clinical trials to determine the suitable selection of adolescent patients for this treatment. In addition, these trials can help guide precision medicine approaches for stimulation protocols.