Objective To summarize the efficacy and safety of transcranial magnetic stimulation( TMS) for anhedonia in patients with depressive disorder and schizophrenia and related influencing factors by metaanalysis. Methods The literature on TMS for anhedonia in patients with depressive disorder and schizophrenia was electronically searched in PubMed, Web of Science, Embase, PsycINFO, CINAHL, The Cochrane Library, China National Knowledge Infrastructure, China Biomedical Database, and WanFang Database. The search period was from database establishment to December 2024. Two researchers independently extracted data from the included literature and performed meta-analysis using RevMan 5.4.1 and Stata 16.0. Results A total of 18 papers with a total of 1 175 patients( 782 with depressive disorder and 393 with schizophrenia) were included. Meta-analysis showed that TMS improved anhedonia in depressive disorder and schizophrenia with a statistically significant difference[ SMD=0.55, 95%CI( 0.16,0.94),Z=2.74,P=0.006]. Subgroup analysis showed that the efficacy in anhedonia using TMS in the left dorsolateral prefrontal cortex( DLPFC) was superior to that in other stimulation sites, and the difference was statistically significant[ SMD=0.67,95%CI( 0.21,1.13), Z=2.86,P=0.004]. The efficacy of using high-frequency TMS greater than 1 Hz to intervene in anhedonia was superior to other stimulation frequencies, and the difference was statistically significant[ SMD=0.53, 95%CI (0.15, 0.90), Z=2.74, P=0.006]. The efficacy of the TMS intervention duration of ≥ 4 weeks was superior to the other intervention durations, and the difference met the statistical threshold criterion[ SMD=0.58, 95%CI( 0.01, 1.16), Z=1.98, P=0.05]. When assessed using the Negative Symptoms Scale, the improvement in anhedonia was better in intervention group than that in control group, and the difference was statistically significant[ SMD=0.53, 95%CI( 0.24,0.83), Z=3.54, P=0.000 4]. TMS had no significant adverse effects relative to other interventions[ RR=0.83, 95%CI( 0.52, 1.33), Z=0.78, P=0.44]. Conclusions Longduration, high-frequency and left DLPFC TMS can significantly improve anhedonia in patients with depressive disorder and schizophrenia without significant adverse effects.
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秦玮琪,李平,魏思懿,李善聪,李博,冷佳慧.经颅磁刺激治疗抑郁症和精神分裂症快感缺失的疗效及安全性Meta分析[J].神经疾病与精神卫生,2025,25(9):616-624 DOI :10.3969/j. issn.1009-6574.2025.09.002.