Abstract：
Repetitive transcranial magnetic stimulation (rTMS) has demonstrated benefits in adults with psychiatric disorders, but its clinical utility in children and young people (CYP) is unclear. This PRISMA systematic review used published and ongoing studies to examine the effects of rTMS on disorder-specific symptoms, mood and neurocognition in CYP with psychiatric disorders. We searched Medline via PubMed, Embase, PsychINFO via OVID, and Clinicaltrials.gov up to July 2023. Eligible studies involved multiple-session (i.e., treatment) rTMS in CYP (≤ 25 years-old) with psychiatric disorders. Two independent raters assessed the eligibility of studies and extracted data using a custom-built form. Out of 78 eligible studies (participant N = 1389), the majority (k = 54; 69%) reported an improvement in at least one outcome measure of disorder-specific core symptoms. Some studies (k = 21) examined rTMS effects on mood or neurocognition,: findings were largely positive. Overall, rTMS was well-tolerated with minimal side-effects. Of 17 ongoing or recently completed studies, many are sham-controlled RCTs with better blinding techniques and a larger estimated participant enrolment. Findings provide encouraging evidence for rTMS-related improvements in disorder-specific symptoms in CYP with different psychiatric disorders. However, in terms of both mood (for conditions other than depression) and neurocognitive outcomes, evidence is limited. Importantly, rTMS is well-tolerated and safe. Ongoing studies appear to be of improved methodological quality; however, future studies should broaden outcome measures to more comprehensively assess the effects of rTMS and develop guidance on dosage (i.e., treatment regimens).
摘要：
重复经颅磁刺激（rTMS）已证明对患有精神疾病的成年人有益。但其在儿童和年轻人（CYP）的临床应用尚不清楚。这项PRISMA系统评价使用已发表和正在进行的研究来检查rTMS对特定疾病症状的影响。CYP伴精神障碍患者的情绪和神经认知。我们通过PubMed搜索了Medline,Embase,心理信息通过OVID，和Clinicaltrials.gov截至2023年7月。符合条件的研究涉及多个会话(即，治疗）CYP（≤25岁）患有精神疾病的rTMS。两名独立的评估者评估了研究的资格，并使用定制的表格提取了数据。在78项符合条件的研究中(参与者N=1389)，大多数(k=54;69%)报告了至少一项疾病特异性核心症状的结局指标有所改善.一些研究（k=21）检查了rTMS对情绪或神经认知的影响，：调查结果基本上是积极的。总的来说,rTMS耐受性良好，副作用最小。在17项正在进行或最近完成的研究中，许多是假对照的RCT,具有更好的致盲技术和更大的估计参与者入学率.研究结果为患有不同精神疾病的CYP中rTMS相关的疾病特异性症状的改善提供了令人鼓舞的证据。然而,就情绪（抑郁症以外的疾病）和神经认知结果而言，证据有限。重要的是,rTMS具有良好的耐受性和安全性。正在进行的研究似乎提高了方法学质量；然而，未来的研究应扩大结果测量范围，以更全面地评估rTMS的影响，并制定剂量指导(即，治疗方案)。
