Combining repetitive transcranial magnetic stimulation with transcranial direct current stimulation in treating psychiatric conditions: A systematic review
Bibliographic record
Abstract
BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) have been thoroughly explored in the treatment of various psychiatric disorders and neuropsychiatric symptoms. However, whether combining rTMS and tDCS can safely and effectively treat psychiatric conditions remains unknown. In this systematic review, we seek to summarize all existing studies that have combined rTMS and tDCS to remedy psychiatric disorders and symptoms. METHODS: We searched four databases in addition to grey literature to identify relevant studies. All abstracts and manuscripts were independently reviewed by two reviewers. For inclusion, studies necessarily consisted of those who received both rTMS and tDCS for a psychiatric condition or symptom. RESULTS: Fourteen studies were reviewed, which had relevance to unipolar depression (five), bipolar disorder (two), obsessive-compulsive disorder (two), Alzheimer's Disease (one), chronic insomnia (two), depressive and anxiety symptoms (one) and stress (one). In three RCTs on unipolar depression, the group receiving both rTMS and tDCS experienced significant reductions in mean Hamilton Depression Rating Scale (HDRS) scores (by 18.22, 16.59 and 20.04) as well as response rates (83.33 % and 91.7 %) and remission rates (83.3 %) - all of which were generally superior compared to treatment with rTMS or tDCS alone. For chronic insomnia, one RCT noted greater improvements in sleep quality/efficiency and depressive symptoms compared to monotherapy. The type and frequency of side effects were comparable to monotherapy, and no significant adverse events were reported. CONCLUSION: The existing evidence suggests that combining rTMS and tDCS alone yields greater symptomatic benefit for unipolar depression compared to either treatment alone. Further studies involving additional protocols and disorders could elucidate the utility of combined treatment.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.020 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.007 |
| Bibliometrics | 0.008 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".