Skip to main content
Top
Published in: Systematic Reviews 1/2021

01-12-2021 | Repetitive Transcranial Magnetic Stimulation | Protocol

Effects of non-invasive brain stimulation in children and young people with psychiatric disorders: a protocol for a systematic review

Authors: Yael D. Lewis, Lucy Gallop, Iain C. Campbell, Ulrike Schmidt

Published in: Systematic Reviews | Issue 1/2021

Login to get access

Abstract

Background

Most psychiatric disorders have their onset in childhood or adolescence, and if not fully treated have the potential for causing life-long psycho-social and physical sequelae. Effective psychotherapeutic and medication treatments exist, but a significant proportion of children and young people do not make a full recovery. Thus, novel, safe, brain-based alternatives or adjuncts to conventional treatments are needed. Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are non-invasive brain stimulation (NIBS) techniques which have shown clinical benefits in adult psychiatric conditions. However, in children and young people their efficacy is not well established. The objective of this study will be to systematically evaluate the evidence on clinical effects of NIBS in children and young people with psychiatric disorders, assessing disorder-specific symptoms, mood and neurocognitive functions.

Methods

We designed and registered a study protocol for a systematic review. We will include randomised and non-randomised controlled trials and observational studies (e.g. cohort, case-control, case series) assessing the effects of NIBS in children and young people (aged ≤ 24 years old) for psychiatric disorders. The primary outcome will be reduction of disorder-specific symptoms. Secondary outcomes will include effects on mood and cognition. A comprehensive search from database inception onwards will be conducted in MEDLINE, EMBASE and PsycINFO. Grey literature will be identified through searching multiple clinical trial registries. Two reviewers will independently screen all citations, full-text articles and abstract data. The methodological quality of the studies will be appraised using appropriate tools. We will provide a narrative synthesis of the evidence and according to heterogeneity will conduct an appropriate meta-analysis. Additional analyses will be conducted to explore the potential sources of heterogeneity.

Discussion

This systematic review will provide a broad and comprehensive evaluation of the evidence on clinical effects of NIBS in children and young people with psychiatric disorders. Our findings will be reported according to the PRISMA guidelines and will be of interest to multiple audiences (including patients, researchers, healthcare professionals and policy-makers). Results will be published in a peer-reviewed journal.

Systematic review registration

Appendix
Available only for authorised users
Literature
2.
go back to reference Sadler K, Vizard T, Ford T, Marcheselli F, Pearce N, Mandalia D, et al. Mental health of children and young people in England, 2017: summary of key findings. Community. 2018. Sadler K, Vizard T, Ford T, Marcheselli F, Pearce N, Mandalia D, et al. Mental health of children and young people in England, 2017: summary of key findings. Community. 2018.
3.
go back to reference Auerbach RP, Mortier P, Bruffaerts R, Alonso J, Benjet C, Cuijpers P, Demyttenaere K, Ebert DD, Green JG, Hasking P, Murray E, Nock MK, Pinder-Amaker S, Sampson NA, Stein DJ, Vilagut G, Zaslavsky AM, Kessler RC, WHO WMH-ICS Collaborators. WHO world mental health surveys international college student project: prevalence and distribution of mental disorders. J Abnorm Psychol. 2018;127(7):623–38. https://doi.org/10.1037/abn0000362.CrossRefPubMedPubMedCentral Auerbach RP, Mortier P, Bruffaerts R, Alonso J, Benjet C, Cuijpers P, Demyttenaere K, Ebert DD, Green JG, Hasking P, Murray E, Nock MK, Pinder-Amaker S, Sampson NA, Stein DJ, Vilagut G, Zaslavsky AM, Kessler RC, WHO WMH-ICS Collaborators. WHO world mental health surveys international college student project: prevalence and distribution of mental disorders. J Abnorm Psychol. 2018;127(7):623–38. https://​doi.​org/​10.​1037/​abn0000362.CrossRefPubMedPubMedCentral
15.
go back to reference Jones PB. Adult mental health disorders and their age at onset. Br J Psychiatry. 2013;202(SUPPL. 54):5–11.CrossRef Jones PB. Adult mental health disorders and their age at onset. Br J Psychiatry. 2013;202(SUPPL. 54):5–11.CrossRef
17.
go back to reference Patel V, Saxena S, Lund C, Thornicroft G, Baingana F, Bolton P, Chisholm D, Collins PY, Cooper JL, Eaton J, Herrman H, Herzallah MM, Huang Y, Jordans MJD, Kleinman A, Medina-Mora ME, Morgan E, Niaz U, Omigbodun O, Prince M, Rahman A, Saraceno B, Sarkar BK, de Silva M, Singh I, Stein DJ, Sunkel C, UnÜtzer JÜ. The Lancet Commission on global mental health and sustainable development. Lancet. 2018;392(10157):1553–98. https://doi.org/10.1016/S0140-6736(18)31612-X.CrossRefPubMed Patel V, Saxena S, Lund C, Thornicroft G, Baingana F, Bolton P, Chisholm D, Collins PY, Cooper JL, Eaton J, Herrman H, Herzallah MM, Huang Y, Jordans MJD, Kleinman A, Medina-Mora ME, Morgan E, Niaz U, Omigbodun O, Prince M, Rahman A, Saraceno B, Sarkar BK, de Silva M, Singh I, Stein DJ, Sunkel C, UnÜtzer JÜ. The Lancet Commission on global mental health and sustainable development. Lancet. 2018;392(10157):1553–98. https://​doi.​org/​10.​1016/​S0140-6736(18)31612-X.CrossRefPubMed
28.
go back to reference Rossi S, Hallett M, Rossini PM, Pascual-Leone A, Avanzini G, Bestmann S, et al. Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clin Neurophysiol. 2009. Rossi S, Hallett M, Rossini PM, Pascual-Leone A, Avanzini G, Bestmann S, et al. Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clin Neurophysiol. 2009.
30.
go back to reference Hanakawa T, Mima T, Matsumoto R, Abe M, Inouchi M, Urayama SI, et al. Stimulus-response profile during single-pulse transcranial magnetic stimulation to the primary motor cortex. Cereb Cortex. 2009. Hanakawa T, Mima T, Matsumoto R, Abe M, Inouchi M, Urayama SI, et al. Stimulus-response profile during single-pulse transcranial magnetic stimulation to the primary motor cortex. Cereb Cortex. 2009.
31.
go back to reference Hoogendam JM, Ramakers GMJ, Di Lazzaro V. Physiology of repetitive transcranial magnetic stimulation of the human brain. Brain Stimul. 2010. Hoogendam JM, Ramakers GMJ, Di Lazzaro V. Physiology of repetitive transcranial magnetic stimulation of the human brain. Brain Stimul. 2010.
37.
go back to reference Dalton B, Bartholdy S, McClelland J, Kekic M, Rennalls SJ, Werthmann J, et al. Randomised controlled feasibility trial of real versus sham repetitive transcranial magnetic stimulation treatment in adults with severe and enduring anorexia nervosa: the TIARA study. BMJ Open. 2018;8(7):1–11.CrossRef Dalton B, Bartholdy S, McClelland J, Kekic M, Rennalls SJ, Werthmann J, et al. Randomised controlled feasibility trial of real versus sham repetitive transcranial magnetic stimulation treatment in adults with severe and enduring anorexia nervosa: the TIARA study. BMJ Open. 2018;8(7):1–11.CrossRef
38.
go back to reference Dunlop K, Woodside B, Olmsted M, Colton P, Giacobbe P, Downar J. Reductions in cortico-striatal hyperconnectivity accompany successful treatment of obsessive-compulsive disorder with dorsomedial prefrontal rTMS. Neuropsychopharmacology. 2016. Dunlop K, Woodside B, Olmsted M, Colton P, Giacobbe P, Downar J. Reductions in cortico-striatal hyperconnectivity accompany successful treatment of obsessive-compulsive disorder with dorsomedial prefrontal rTMS. Neuropsychopharmacology. 2016.
40.
go back to reference Blumberger DM, Vila-Rodriguez F, Thorpe KE, Feffer K, Noda Y, Giacobbe P, Knyahnytska Y, Kennedy SH, Lam RW, Daskalakis ZJ, Downar J. Effectiveness of theta burst versus high-frequency repetitive transcranial magnetic stimulation in patients with depression (THREE-D): a randomised non-inferiority trial. Lancet. 2018;391(10131):1683–92. https://doi.org/10.1016/S0140-6736(18)30295-2.CrossRefPubMed Blumberger DM, Vila-Rodriguez F, Thorpe KE, Feffer K, Noda Y, Giacobbe P, Knyahnytska Y, Kennedy SH, Lam RW, Daskalakis ZJ, Downar J. Effectiveness of theta burst versus high-frequency repetitive transcranial magnetic stimulation in patients with depression (THREE-D): a randomised non-inferiority trial. Lancet. 2018;391(10131):1683–92. https://​doi.​org/​10.​1016/​S0140-6736(18)30295-2.CrossRefPubMed
41.
go back to reference Fitzgerald PB, Daskalakis ZJ. The effects of repetitive transcranial magnetic stimulation in the treatment of depression. Expert Rev Med Devices. 2011. Fitzgerald PB, Daskalakis ZJ. The effects of repetitive transcranial magnetic stimulation in the treatment of depression. Expert Rev Med Devices. 2011.
42.
go back to reference Milev RV, Giacobbe P, Kennedy SH, Blumberger DM, Daskalakis ZJ, Downar J, Modirrousta M, Patry S, Vila-Rodriguez F, Lam RW, MacQueen GM, Parikh SV, Ravindran AV, the CANMAT Depression Work Group. Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 clinical guidelines for the management of adults with major depressive disorder: section 4. Neurostimulation treatments. Can J Psychiatr. 2016;61(9):561–75. https://doi.org/10.1177/0706743716660033.CrossRef Milev RV, Giacobbe P, Kennedy SH, Blumberger DM, Daskalakis ZJ, Downar J, Modirrousta M, Patry S, Vila-Rodriguez F, Lam RW, MacQueen GM, Parikh SV, Ravindran AV, the CANMAT Depression Work Group. Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 clinical guidelines for the management of adults with major depressive disorder: section 4. Neurostimulation treatments. Can J Psychiatr. 2016;61(9):561–75. https://​doi.​org/​10.​1177/​0706743716660033​.CrossRef
44.
go back to reference Fregni F, Marcolin MA, Myczkowski M, Amiaz R, Hasey G, Rumi DO, Rosa M, Rigonatti SP, Camprodon J, Walpoth M, Heaslip J, Grunhaus L, Hausmann A, Pascual-Leone A. Predictors of antidepressant response in clinical trials of transcranial magnetic stimulation. Int J Neuropsychopharmacol. 2006;9(6):641–54. https://doi.org/10.1017/S1461145705006280.CrossRefPubMed Fregni F, Marcolin MA, Myczkowski M, Amiaz R, Hasey G, Rumi DO, Rosa M, Rigonatti SP, Camprodon J, Walpoth M, Heaslip J, Grunhaus L, Hausmann A, Pascual-Leone A. Predictors of antidepressant response in clinical trials of transcranial magnetic stimulation. Int J Neuropsychopharmacol. 2006;9(6):641–54. https://​doi.​org/​10.​1017/​S146114570500628​0.CrossRefPubMed
49.
go back to reference Masuda F, Nakajima S, Miyazaki T, Tarumi R, Ogyu K, Wada M, Tsugawa S, Croarkin PE, Mimura M, Noda Y. Clinical effectiveness of repetitive transcranial magnetic stimulation treatment in children and adolescents with neurodevelopmental disorders: a systematic review. Autism. 2019;23(7):1614–29. https://doi.org/10.1177/1362361318822502.CrossRefPubMed Masuda F, Nakajima S, Miyazaki T, Tarumi R, Ogyu K, Wada M, Tsugawa S, Croarkin PE, Mimura M, Noda Y. Clinical effectiveness of repetitive transcranial magnetic stimulation treatment in children and adolescents with neurodevelopmental disorders: a systematic review. Autism. 2019;23(7):1614–29. https://​doi.​org/​10.​1177/​1362361318822502​.CrossRefPubMed
50.
go back to reference Gomez L, Vidal B, Morales L, Baez M, Maragoto C, Galvizu R, et al. Low frequency repetitive transcranial magnetic stimulation in children with attention deficit hyperactivity disorder Preliminary results. Brain Stimul. 2014;7:757–69.CrossRef Gomez L, Vidal B, Morales L, Baez M, Maragoto C, Galvizu R, et al. Low frequency repetitive transcranial magnetic stimulation in children with attention deficit hyperactivity disorder Preliminary results. Brain Stimul. 2014;7:757–69.CrossRef
52.
go back to reference Krishnan C, Santos L, Peterson MD, Ehinger M. Safety of noninvasive brain stimulation in children and adolescents. Brain Stimul. 2015. Krishnan C, Santos L, Peterson MD, Ehinger M. Safety of noninvasive brain stimulation in children and adolescents. Brain Stimul. 2015.
53.
go back to reference Woods AJ, Antal A, Bikson M, Boggio PS, Brunoni AR, Celnik P, Cohen LG, Fregni F, Herrmann CS, Kappenman ES, Knotkova H, Liebetanz D, Miniussi C, Miranda PC, Paulus W, Priori A, Reato D, Stagg C, Wenderoth N, Nitsche MA. A technical guide to tDCS, and related non-invasive brain stimulation tools. Clin Neurophysiol. 2016;127(2):1031–48 Available from: https://doi.org/10.1016/j.clinph.2015.11.012.CrossRefPubMed Woods AJ, Antal A, Bikson M, Boggio PS, Brunoni AR, Celnik P, Cohen LG, Fregni F, Herrmann CS, Kappenman ES, Knotkova H, Liebetanz D, Miniussi C, Miranda PC, Paulus W, Priori A, Reato D, Stagg C, Wenderoth N, Nitsche MA. A technical guide to tDCS, and related non-invasive brain stimulation tools. Clin Neurophysiol. 2016;127(2):1031–48 Available from: https://​doi.​org/​10.​1016/​j.​clinph.​2015.​11.​012.CrossRefPubMed
54.
go back to reference Stagg CJ, Antal A, Nitsche MA. Physiology of transcranial direct current stimulation. J ECT. 2018. Stagg CJ, Antal A, Nitsche MA. Physiology of transcranial direct current stimulation. J ECT. 2018.
60.
go back to reference Buchanan DM, Bogdanowicz T, Khanna N, Lockman-dufour G, Robaey P, Angiulli AD. Brain sciences. Systematic review on the safety and tolerability of transcranial direct current stimulation in children and adolescents; 2021. Buchanan DM, Bogdanowicz T, Khanna N, Lockman-dufour G, Robaey P, Angiulli AD. Brain sciences. Systematic review on the safety and tolerability of transcranial direct current stimulation in children and adolescents; 2021.
62.
go back to reference Palm U, Segmiller FM, Natascha A, Freisleder EF. Transcranial direct current stimulation in children and adolescents: a comprehensive review; 2016. p. 1219–34. Palm U, Segmiller FM, Natascha A, Freisleder EF. Transcranial direct current stimulation in children and adolescents: a comprehensive review; 2016. p. 1219–34.
63.
go back to reference Hameed MQ, Dhamne SC, Gersner R, Kaye HL, Oberman LM, Pascual-Leone A, et al. Transcranial magnetic and direct current stimulation in children. Curr Neurol Neurosci Rep. 2017;17(2). Hameed MQ, Dhamne SC, Gersner R, Kaye HL, Oberman LM, Pascual-Leone A, et al. Transcranial magnetic and direct current stimulation in children. Curr Neurol Neurosci Rep. 2017;17(2).
66.
go back to reference Gogtay N, Giedd JN, Lusk L, Hayashi KM, Greenstein D, Vaituzis AC, et al. Dynamic mapping of human cortical development during childhood through early adulthood. Proc Natl Acad Sci U S A. 2004. Gogtay N, Giedd JN, Lusk L, Hayashi KM, Greenstein D, Vaituzis AC, et al. Dynamic mapping of human cortical development during childhood through early adulthood. Proc Natl Acad Sci U S A. 2004.
68.
go back to reference Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: Elaboration and explanation. BMJ. 2015. Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: Elaboration and explanation. BMJ. 2015.
71.
go back to reference Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Syst Rev. 2016. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Syst Rev. 2016.
72.
go back to reference Li T, Higgins JPT, Deeks JJ. Collecting data. In: Cochrane handbook for systematic reviews of interventions; 2019. p. 109–41.CrossRef Li T, Higgins JPT, Deeks JJ. Collecting data. In: Cochrane handbook for systematic reviews of interventions; 2019. p. 109–41.CrossRef
73.
go back to reference Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: A revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:1–8. Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: A revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:1–8.
74.
go back to reference Sterne JAC, Hernán MA, Reeves BC, Savović J, Berkman ND, Viswanathan M, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016;355:4–10. Sterne JAC, Hernán MA, Reeves BC, Savović J, Berkman ND, Viswanathan M, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016;355:4–10.
76.
go back to reference Higgins JPT, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011. Higgins JPT, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011.
77.
go back to reference Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J, et al. GRADE guidelines: 1. Introduction - GRADE evidence profiles and summary of findings tables. J Clin Epidemiol. 2011. Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J, et al. GRADE guidelines: 1. Introduction - GRADE evidence profiles and summary of findings tables. J Clin Epidemiol. 2011.
Metadata
Title
Effects of non-invasive brain stimulation in children and young people with psychiatric disorders: a protocol for a systematic review
Authors
Yael D. Lewis
Lucy Gallop
Iain C. Campbell
Ulrike Schmidt
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Systematic Reviews / Issue 1/2021
Electronic ISSN: 2046-4053
DOI
https://doi.org/10.1186/s13643-021-01627-3

Other articles of this Issue 1/2021

Systematic Reviews 1/2021 Go to the issue