Table 6

Summary of stimulation protocol, statistical analyses, main results and additional groups and measures (part 1 of 2)

StudyProtocolFollow-upStatistical analysisReported resultsAdditional groupsAdditional pre/post measures
De Lima et al. (86) (2019)5 consecutive days1 wkANOVA repeated-measuresAnxiety and depression symptoms did not differ between real and sham tDCS. Physical symptoms of stress were reduced at the end of treatment and at follow-up in the tDCS group v. the sham groupNoneAnxiety: BAI Global evaluation: PANAS
Deppermann et al. (115) (2014)5 daily sessions; 3 wkNRANOVA repeated-measuresNo differences in real v. sham rTMS. Both groups showed improvement in anxiety symptoms post-iTBS v. baselineHealthy controls; only for fNIRSPhysiological: CAQ Brain activation: fNIRS Cognitive: verbal fluency
Diefenbach et al. (116) (2016)5 daily sessions; 6 wk3 mo, 6 mo (only a subset not included in statistical analysis)ANOVA repeated- measures; planned contrastsAnxiety symptoms improved in post- v. pre- measurements in rTMS and sham groups that persisted at 3 mo follow-up only in the rTMS group. Worry and depressive symptoms improved only in the rTMS group at the end of treatment and at 3 mo follow-up. Brain activation increased after rTMS and tended to decrease after shamNoneAnxiety/mood: DASS-DEP Brain activation: fMRI during gambling task
Dilkov et al. (87) (2017)6 wk; 5 sessions/wk for the first 4 wk; during the wk 5, sessions reduced to 3 times/wk; during wk 6, sessions reduced to 2 times/wk2 wk and 6 wk after the end of treatmentANOVA repeated-measuresAnxiety and depressive symptoms improved in the stimulation v. sham condition at the end of treatment and the 2 follow-upsNoneGlobal evaluation: CGI
Herrmann et al. (117) (2017)2 sessions3 moANOVA repeated-measures; t test2 sessions of rTMS reduced anxiety and avoidance ratings compared to the sham groupNoneAnxiety: AQ-avoidance subscale; BAT
Huang et al. (118) (2018)10 consecutive days2 wk, 1 moANOVA repeated- measuresAnxiety, insomnia and depressive symptoms improved in the rTMS group v. the sham group at the end of treatment and the 2 follow-upsNoneNR
Mantovani et al. (119) (2013)5 d/wk; 4 wk double- blind + 4 weeks real*1, 3 and 6 moANOVA repeated- measures; t test4 weeks rTMS v. sham: improvement in panic symptoms but not depression. 8 weeks of rTMS v. pre- treatment: improvement in panic and depressive symptoms, global assessment, and social adjustmentNoneAnxiety: PDSS, PDSS-SR Mood: BDI; ZUNG-SAS Global evaluation: CGI; PGI; SASS
Movahed et al. (120) (2018)4 wk2 moANOVA repeated- measuresWorry, anxiety and depression scores were reduced after cathodal tDCS and pharmacotherapy v. sham tDCS. Pharmacotherapy was stronger than tDCS in reducing worry; tDCS was stronger in reducing depression. Anxiety symptoms did not differ after cathodal tDCS compared to pharmacotherapyPharmacotherapyNR
Nasiri et al. (121) (2020)10 daily sessions; 2 wk3 moMANCOVAWorry, anxiety and anxiety sensitivity improved after UP + tDCS v. UP alone at the end of treatment and at follow-upWaiting listAnxiety: ASI; IUS; PSWQ
Notzon et al. (88) (2015)Single sessionNRANOVA repeated- measuresiTBS increased sympathetic activity during the spider scene in both phobic and healthy participantsHealthy controls (real and sham)Anxiety: FSQ; ASI Global evaluation: IPQ; SUDS; DS Physiological: HR; SCL Brain activation: fNIRS
Prasko et al. (122) (2007)5 daily sessions; 2 wk2 wkNonparametric repeated- measures ANOVAAnxiety symptoms and psychopathology global scores improved after both real and sham rTMSNoneAnxiety: BAI Global evaluation: CGI
  • ANOVA = analysis of variance; AQ = Acrophobia Questionnaire; ASI = Anxiety Sensitivity Index; BAI = Beck Anxiety Inventory; BAT = Behavioral Avoidance Test; BDI = Beck Depression Inventory; CAQ = Cardiac Anxiety Questionnaire; CGI = Clinical Global Impression Scale; DASS-DEP = Depression-Anxiety Scales Depression Subscale; DS = Disgust Scale; fMRI = functional magnetic resonance imaging; fNIRS = functional near-infrared spectroscopy; FSQ = Fear of Spiders Questionnaire; HR = heart rate; IPQ = Igroup Presence Questionnaire; iTBS = intermittent theta burst stimulation; IUS = Intolerance of Uncertainty Scale; MANCOVA = multivariate analysis of covariance; NR = not reported; PANAS = Positive and Negative Affect Schedule; PDSS(−SR) = Panic Disorder Severity Scale (self-report); PGI = Patient Global Impression; PSWQ = Penn State Worry Questionnaire; rTMS = repetitive transcranial magnetic stimulation; SASS = Self-reported Social Adaptation Scale; SCL = skin conductance level; SUDS = Subjective Units of Discomfort Scale; tDCS = transcranial direct current stimulation; UP = unified protocol; ZUNG-SAS= Zung-Self Administered Scale.

  • * In our analysis, we included data for the baseline and the first 4 weeks of rTMS treatment.