A Systematic Review of the Safety and Tolerability of Theta Burst Stimulation in Children and Adolescents

A Systematic Review of the Safety and Tolerability of Theta Burst Stimulation in Children and Adolescents

Authors
Elmaghraby, R. Sun, Q. Ozger, C. Shekunov, J. Romanowicz, M. Croarkin, P. E.
Year
2021
Journal
Neuromodulation
Volume
Pages
9
Objectives Theta burst stimulation (TBS) is often used in clinical practice and research protocols for adults with neuropsychiatric disorders. There are substantial knowledge gaps related to the application of TBS in children and adolescents. This systematic review examined the safety and tolerability of TBS in children and adolescents. Materials and Methods A systematic review of human TBS studies in children and adolescents was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The following inclusion criteria were applied: 1) articles in English language only; 2) studies that included child and adolescent participants (up to 21 years of age); 3) studies that administered intermittent TBS or continuous TBS or both to participants; 4) studies that had an outcome measure; and 5) availability of full text material. The primary outcome measures were tolerability and safety. When feasible, the clinical effects were reviewed. Results Twenty relevant articles met the criteria for inclusion. The reported adverse events were mild and similar to what is noted in adult studies. The most common symptom was headache. One case report described a seizure induced by TBS. Collectively, the studies were heterogeneous but the methodologic quality of randomized trials was high. Conclusions TBS interventions in children may have similar safety, tolerability, and feasibility as compared to adults. However, long-term, follow-up studies of TBS are lacking. Future dose-ranging studies with systematic assessment of adverse events will be important in the translation of findings with TBS from adults to youth.

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Type of intervention

Treatment and Child Welfare Interventions

Topic

Mental Health Problems and Disorders

Emotional Problems

Depression and Depressed Mood

Anxiety Problems

Trauma/ Post-traumatic Stress Disorder (PTSD)

Autism Spectrum Disorder

Other Problems

Tics and Tourettes

Biological Risk Factors, Diseases and Symptoms

Side Effects

Age group

Adolescents (13-18 years)

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