SYSTEMATIC REVIEW article
Front. Psychiatry
Sec. Mood Disorders
The Impact of Transcranial Magnetic Stimulation on Serum Thyroid-Stimulating Hormone Levels in Depressive Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Provisionally accepted
- 1School of Health Management, Gansu University of Chinese Medicine, Lanzhou, China
- 2Department of Psychology, the third people's hospital of lanzhou, Lanzhou, China
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Introduction: The findings of current research on the impact of transcranial magnetic stimulation (TMS) on thyroid function are inconsistent. This study investigated the effects of TMS on the function of the hypothalamic-pituitary-thyroid axis (HPT axis) in patients with depression through meta-analysis, with a focus on the thyroid-stimulating hormone (TSH). Methods: From inception to November 27, 2025, we conducted a systematic search of randomized controlled trials investigating TMS therapy for depression across PubMed, Embase, Web of Science, the Cochrane Library, and Chinese biomedical databases. Two independent reviewers screened the retrieved abstracts and full-text articles using our predefined search strategy, in duplicate, to assess eligibility criteria, extract data, and evaluate the risk of bias. Due to the high heterogeneity, a random-effects model was selected. The review protocol was prospectively registered in PROSPERO (CRD420251006441). Results: Meta-analyses of the 5 randomized controlled trials included demonstrated that TMS treatment had no statistically significant effect on TSH levels in depressed patients (Z = 0.06, P = 0.952). Sensitivity analyses and publication bias tests(Egger's regression test, t = 1.01, P < 0.386) supported the robustness of the results. TSH levels in postpartum depressed patients were also not statistically significantly modulated by TMS (Z = 1.71, P = 0.087), but the results were not robust. Discussion: This meta-analysis indicates that TMS exerts no statistically significant influence on TSH concentrations in individuals with depression, implying a negligible effect on the HPT axis. However, it is important to emphasize that this constitutes only initial preliminary evidence. Although the findings are consistent across the depressive cohort, the data about postpartum depression remain inconclusive, highlighting the necessity for additional investigation. These results enhance our understanding of TMS's neuroendocrine mechanisms within the context of depressive disorder.
Keywords: Depression, Meta-analysis, randomized controlled trials, thyroid-stimulating hormone, Transcranial Magnetic Stimulation
Received: 01 Oct 2025; Accepted: 02 Jan 2026.
Copyright: © 2026 Ma, Wei, Pan and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Chunyan Wei
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