Effectiveness of Different Repetitive Transcranial Magnetic Stimulation Modalities

A frequentist network meta-analysis (NMA) using a random-effects model was employed to synthesize both direct and indirect evidence concurrently. All analyses were conducted using Stata statistical software version 16.0 and Review Manager software version 5.331. The effect size for continuous variables was assessed using mean difference (MD) with a 95% confidence interval (CI). In cases where a closed loop existed, statistical inconsistency between direct and indirect evidence was evaluated through local (node-splitting method) and global (design-by-treatment interaction model) approaches32. If the P-value exceeded 0.05, it indicated no statistically significant inconsistency, and the consistency model was applied for further analysis. A network plot was generated to illustrate the relationships among the different interventions, where the size of the nodes represented the sample size of each intervention, and the line thickness indicated the number of randomized controlled trials (RCTs) with direct comparisons. The surface under the cumulative ranking curve (SUCRA) probabilities were calculated to assess the efficacy of various treatment strategies, with higher SUCRA values indicating a more favorable outcome33. Cumulative probability line charts were also produced. Lastly, potential publication bias in the NMA was evaluated using a comparison-adjusted funnel plot.