We examined the efficacy and acceptability of non-invasive brain stimulation in adult unipolar and bipolar depression. Randomised sham-controlled trials of transcranial direct current stimulation (tDCS), transcranial magnetic stimulation (TMS) and theta-burst stimulation (TBS), without co-initiation of another treatment, were included. We analysed effects on response, remission, all-cause discontinuation rates and continuous depression severity measures. Fifty-six studies met our criteria for inclusion (N = 3058, mean age = 44.96 years, 61.73% female). Response rates demonstrated efficacy of high-frequency rTMS over the left DLPFC (OR = 3.75, 95% CI [2.44; 5.75]), right-sided low-frequency rTMS (OR = 7.44, 95%CI [2.06; 26.83]) bilateral rTMS (OR = 3.68,95%CI [1.66; 8.13]), deep TMS (OR = 1.69, 95%CI [1.003; 2.85]), intermittent TBS (OR = 4.70, 95%CI [1.14; 19.38]) and tDCS (OR = 4.17, 95% CI [2.25; 7.74]); but not for continuous TBS, bilateral TBS or synchronised TMS. There were no differences in all-cause discontinuation rates. The strongest evidence was for high-frequency rTMS over the left DLPFC. Intermittent TBS provides an advance in terms of reduced treatment duration. tDCS is a potential treatment for non-treatment resistant depression. To date, there is not sufficient published data available to draw firm conclusions about the efficacy and acceptability of TBS and sTMS.

我们检查了成人单相和双相抑郁症的非侵入性脑刺激的功效和可接受性。包括经颅直流电刺激（tDCS），经颅磁刺激（TMS）和θ-爆裂刺激（TBS）的假手术对照试验，但未同时开始其他治疗。我们分析了对缓解，缓解，全因停药率和持续抑郁程度的影响。五十六项研究符合我们的纳入标准（N = 3058，平均年龄= 44.96岁，女性占61.73％）。响应率显示了高频rTMS优于左DLPFC（OR = 3.75，95％CI [2.44; 5.75]），右侧低频rTMS（OR = 7.44，95％CI [2.06; 26.83]）双侧的疗效rTMS（OR = 3.68,95％CI [1.66; 8.13]），深TMS（OR = 1.69，95％CI [1.003; 2.85]），间歇性TBS（OR = 4.70，95％CI [1.14; 19.38]）和tDCS（OR = 4.17，95％CI [2.25; 7.74]）；但不适用于连续TBS，双边TBS或同步TMS。全因停药率无差异。最有力的证据是左DLPFC上方有高频rTMS。间歇性TBS在缩短治疗时间方面取得了进步。tDCS是抗非治疗性抑郁症的潜在治疗方法。迄今为止，