Efficacy of Non‐Invasive Brain Stimulation on the Treatment of Late Life Depression: A Systematic Review and Network Meta‐Analysis

Published October 23, 2026. Across randomized trials in adults aged 60 and older, bilateral ECT and 10 Hz left-prefrontal rTMS showed the most consistent benefits compared with sham. Other highly ranked approaches were supported by less evidence, so ranking alone should not be treated as proof of superiority.

Lin C, Chen W, Liu Y, Lin H, Lee S, Yu C, Chiu C, Chiang C, Chen P, Cheng Y.
Acta Psychiatrica Scandinavica · Publication date: 2026-10-23
Added to site: 2026-10-25
DOI: 10.1111/acps.70144

Published October 23, 2026. Added to Neurofeedback.com October 25, 2026.

Modalities

rTMS, ECT, Non-invasive brain stimulation

Clinical focus

Late-life depression, Depressive symptoms, Response and remission

Population

Adults aged 60 years or older with major depressive disorder

Sample

25 randomized controlled trials with 1,344 participants across 15 brain-stimulation modalities

Intervention / method

Three databases were searched through June 2025; depressive-symptom change was primary, with response and remission as secondary outcomes, and certainty was assessed with GRADE

Comparator

Network of sham-controlled and active brain-stimulation comparisons

Clinician summary

The network included 25 RCTs, 1,344 participants and 15 modalities. Bilateral ECT showed SMD 1.13, 95% CI 0.37 to 1.90, and 10 Hz left-DLPFC rTMS showed SMD 0.42, 95% CI 0.02 to 0.81, versus sham. Both retained moderate-certainty evidence across reported efficacy outcomes, although inconsistency was detected in the symptom-severity network.

How to interpret the findings

Network estimates combine direct and indirect comparisons and depend on cross-trial similarity. The symptom-severity network showed inconsistency, and data for many modalities were sparse. The checked abstract does not provide treatment-session detail, adverse-event synthesis, attrition, publication-bias results or study-level risk-of-bias counts. ECT and rTMS have different workflows and safety considerations, so effect rankings are not interchangeable care recommendations.

Equipment and disclosures

The review evaluated multiple ECT, rTMS and other stimulation protocols. The checked abstract does not establish a superior commercial device and makes no BrainMaster attribution.

Registered as PROSPERO CRD42024628560. Funding and competing-interest details were not available in the checked PubMed abstract or retained Crossref record. No indexed correction, retraction or expression-of-concern relation appeared in those records; this is a bounded check. AI-assisted source review.

Related evidence

Compare findings from the same clinical area, including mixed results.

• Effectiveness of rTMS vs. Pharmacotherapy in Late-Life Treatment-Resistant Depression: An Observational Study of Individual Participant Data From Two Randomized Clinical Trials · Positive with limitations