Ren et al., Repetitive Transcranial magnetic stimulation versus electroconvulsive therapy for major depression: A systematic review and meta-analysis. PMID 24556538
Meta-analysis of ECT vs rTMS in depression
ECT was superior to high frequency rTMS in terms of response, remission while discontinuation was not significantly different between the two treatments.
There was insufficient data on medium or long term efficacy.
Results based on 3 studies suggested that specific cognitive domains such as visual memory and verbal fluency were more impaired in patients receiving ECT.
The review highlights a lack of good quality trials comparing the long-term outcome and cognitive effects of rTMS and ECT, especially using approaches to optimize stimulus delivery and reduce clinical heterogeneity.