The effect of rTMS to overall ADHD symptoms is small and not significant (SMD -0.24; 95% CI -0.58; 0.1), but it alleviated inattention symptoms more than sham stimulation (-0.76; 95% CI -1.16; -0.53). However, the applicability of rTMS in Finland is poor since the only indication for rTMS approved by the authorities is the treatment of depression. The quality of evidence is low due to moderate risk of bias, imprecision and publication bias.
Reference | Study type | Population | Intervention and comparison | Outcomes | Risk of bias [Table «Additional comments for included studies...»2. Additional comments] |
---|---|---|---|---|---|
«Chen CM, Liang SC, Sun CK, ym. A meta-analysis of ...»1 | MA including randomized sham-controlled trials | RCTs of rTMS in ADHD patients, from January 1990 (inception) to January 2023 without no restrictions on country or language. | Repetitive transcranial magnetic stimulation (rTMS) compared to sham | Overall improvement in ADHD symptoms. Secondary outcomes were the association of rTMS with improvement in different ADHD symptoms. |
Moderate |
RCT=randomized controlled trial; SR=systematic review; MA=meta-analysis |
Reference | Comments |
---|---|
«Chen CM, Liang SC, Sun CK, ym. A meta-analysis of ...»1 |
|
Results
Reference | Number of studies and number of patients (I/C) | Follow-up time | Absolute number of events (%) I | Absolute number of events (%) C | Relative effect: SMD (95% CI) |
---|---|---|---|---|---|
I= intervention; C=comparison; CI=confidence interval | |||||
«Chen CM, Liang SC, Sun CK, ym. A meta-analysis of ...»1 | 5 RCTs and 158 participants | NR | NR | NR | -0.24 (-0.58; 0.1), p = 0.17 |
Level of evidence: low The quality of evidence is downgraded due to (imprecision and publication bias). |
Reference | Number of studies and number of patients (I/C) | Follow-up time | Absolute number of events (%) I | Absolute number of events (%) C | Relative effect: SMD (95% CI) |
---|---|---|---|---|---|
I= intervention; C=comparison; CI=confidence interval | |||||
«Chen CM, Liang SC, Sun CK, ym. A meta-analysis of ...»1 | 3 RCTs and 117 participants | NR | NR | NR | -0.76 (-1.16; -0.35), p = 0.0002 |
Level of evidence: low The quality of evidence is downgraded due to (imprecision and publication bias). |
Reference | Number of studies and number of patients (I/C) | Follow-up time | Absolute number of events (%) I | Absolute number of events (%) C | Relative effect: SMD (95% CI) |
---|---|---|---|---|---|
I= intervention; C=comparison; CI=confidence interval | |||||
«Chen CM, Liang SC, Sun CK, ym. A meta-analysis of ...»1 | 2 RCTs and 91 participants | NR | NR | NR | 0.04 (-0.41; 0.49), p=0.86 |
Level of evidence: low The quality of evidence is downgraded due to (imprecision and publication bias). |
Reference | Number of studies and number of patients (I/C) | Follow-up time | Absolute number of events (%) I | Absolute number of events (%) C | Relative effect: SMD (95% CI) |
---|---|---|---|---|---|
I= intervention; C=comparison; CI=confidence interval | |||||
«Chen CM, Liang SC, Sun CK, ym. A meta-analysis of ...»1 | 2 RCTs and 91 participants | NR | NR | NR | -0.43 (-1.46; 0.60), p=0.41 |
Level of evidence: low The quality of evidence is downgraded due to (imprecision and publication bias). |
Reference | Number of studies and number of patients (I/C) | Follow-up time | Absolute number of events (%) I | Absolute number of events (%) C | Relative effect: SMD (95% CI) |
---|---|---|---|---|---|
I= intervention; C=comparison; CI=confidence interval | |||||
«Chen CM, Liang SC, Sun CK, ym. A meta-analysis of ...»1 | 3 RCTs and 117 participants | NR | NR | NR | -0.02 (-0.58; 0.55), p=0.95 |
Level of evidence: low The quality of evidence is downgraded due to (imprecision and publication bias). |