{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T06:18:21Z","timestamp":1787811501522,"version":"build-2784847793"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Post-stroke depression (PSD) is a common neuropsychiatric complication after stroke and is associated with poorer functional recovery and quality of life. This systematic review and meta-analysis evaluated the efficacy and safety of non-invasive brain stimulation (NIBS), specifically repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), for PSD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, Embase, Web of Science, the Cochrane Library, and Scopus were searched from inception to April 2025. Randomized controlled trials comparing rTMS or tDCS with sham stimulation, placebo, usual care, or other control interventions in adults with PSD were eligible. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated for depressive symptoms and secondary outcomes. Fixed- or random-effects models were selected according to heterogeneity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seventeen randomized controlled trials involving 917 participants were included. Compared with control interventions, NIBS was associated with a greater reduction in depressive symptoms (SMD\u202f=\u202f\u22121.24, 95% CI: \u22121.74 to \u22120.73,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Subgroup analyses showed significant effects for both rTMS (SMD\u202f=\u202f\u22121.06, 95% CI: \u22121.59 to \u22120.52) and tDCS (SMD\u202f=\u202f\u22121.94, 95% CI: \u22123.25 to \u22120.63), although the difference between modalities was not statistically significant. High-frequency rTMS showed a numerically larger effect than low-frequency rTMS, but the subgroup difference was not significant. NIBS was also associated with improvements in activities of daily living (SMD\u202f=\u202f0.80) and quality of life (SMD\u202f=\u202f0.83). No serious stimulation-related adverse events were reported.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Current randomized evidence suggests that rTMS and tDCS may improve depressive symptoms in patients with PSD and appear generally well tolerated. However, the certainty of these findings is limited by substantial heterogeneity, small sample sizes in several trials, and variation in stimulation protocols. Further well-designed trials are needed to define optimal stimulation parameters, treatment timing, and long-term clinical effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyg.2026.1870615","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T05:34:50Z","timestamp":1787808890000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of non-invasive brain stimulation for post-stroke depression: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Peizhang","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine, The First Dongguan Affiliated Hospital, Guangdong Medical University","place":["Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haojie","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, The First Dongguan Affiliated Hospital, Guangdong Medical University","place":["Guangdong, China"]},{"name":"Dongguan Key Laboratory of Intelligent Rehabilitation","place":["Dongguan, Guangdong, China"]},{"name":"Dongguan Rehabilitation Medicine Engineering Technology Research Center","place":["Dongguan, Guangdong, China"]},{"name":"Department of Rehabilitation Medicine, The Second School of Clinical Medicine, Guangdong Medical University","place":["Dongguan, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Huang","sequence":"additional","affiliation":[{"name":"School of Chinese Medicine, Hong Kong Baptist University","place":["Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changjie","family":"Mei","sequence":"additional","affiliation":[{"name":"School of Chinese Medicine, Hong Kong Baptist University","place":["Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linrong","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, The First Dongguan Affiliated Hospital, Guangdong Medical University","place":["Guangdong, China"]},{"name":"Dongguan Key Laboratory of Intelligent Rehabilitation","place":["Dongguan, Guangdong, China"]},{"name":"Dongguan Rehabilitation Medicine Engineering Technology Research Center","place":["Dongguan, Guangdong, China"]},{"name":"Department of Rehabilitation Medicine, The Second School of Clinical Medicine, Guangdong Medical University","place":["Dongguan, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yakun","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, The First Dongguan Affiliated Hospital, Guangdong Medical University","place":["Guangdong, China"]},{"name":"Department of Neurology, The First Dongguan Affiliated Hospital, Guangdong Medical University","place":["Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1016\/S0278-5846(01)00158-0","article-title":"Research into the specificity of depression after stroke: a review on an unresolved issue","volume":"25","author":"Aben","year":"2001","journal-title":"Prog. Neuro-Psychopharmacol. Biol. Psychiatry"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1038\/s41398-019-0439-0","article-title":"Double-blind, randomized pilot clinical trial targeting alpha oscillations with transcranial alternating current stimulation (tACS) for the treatment of major depressive disorder (MDD)","volume":"9","author":"Alexander","year":"2019","journal-title":"Transl. Psychiatry"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"Cd003689","DOI":"10.1002\/14651858.CD003689.pub4","article-title":"Pharmacological, psychological and non-invasive brain stimulation interventions for preventing depression after stroke","volume":"2020","author":"Allida","year":"2020","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1136\/emermed-2020-209567","article-title":"Population, intervention, comparison, outcomes and study (PICOS) design as a framework to formulate eligibility criteria in systematic reviews","volume":"37","author":"Amir-Behghadami","year":"2020","journal-title":"Emerg. Med. J."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1589\/jpts.29.505","article-title":"Effect of transcranial direct current stimulation of stroke patients on depression and quality of life","volume":"29","author":"An","year":"2017","journal-title":"J. Phys. Ther. Sci."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1192\/bjp.bp.111.107664","article-title":"Natural history, predictors and outcomes of depression after stroke: systematic review and meta-analysis","volume":"202","author":"Ayerbe","year":"2013","journal-title":"Br. J. Psychiatry"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"2108","DOI":"10.3389\/fpsyg.2018.02108","article-title":"Brain state-dependent brain stimulation","volume":"9","author":"Bergmann","year":"2018","journal-title":"Front. Psychol."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/j.jad.2018.05.026","article-title":"A systematic review of noninvasive brain stimulation for post-stroke depression","volume":"238","author":"Bucur","year":"2018","journal-title":"J. Affect. Disord."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"Ed000142","DOI":"10.1002\/14651858.ED000142","article-title":"Updated guidance for trusted systematic reviews: a new edition of the Cochrane handbook for systematic reviews of interventions","volume":"10","author":"Cumpston","year":"2019","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/j.jns.2014.09.038","article-title":"Poststroke depression and its multifactorial nature: results from a prospective longitudinal study","volume":"347","author":"De Ryck","year":"2014","journal-title":"J. Neurol. Sci."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"930","DOI":"10.3390\/ijerph20020930","article-title":"Effectiveness evaluation of repetitive transcranial magnetic stimulation therapy combined with mindfulness-based stress reduction for people with post-stroke depression: a randomized controlled trial","volume":"20","author":"Duan","year":"2023","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1016\/j.neuron.2010.03.035","article-title":"Direct current stimulation promotes BDNF-dependent synaptic plasticity: potential implications for motor learning","volume":"66","author":"Fritsch","year":"2010","journal-title":"Neuron"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1016\/j.brs.2016.10.010","article-title":"The effects of 10-Hz repetitive transcranial magnetic stimulation on depression in chronic stroke patients","volume":"10","author":"Gu","year":"2017","journal-title":"Brain Stimul."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1862","DOI":"10.1212\/WNL.0b013e318271f848","article-title":"Selective serotonin reuptake inhibitors and brain hemorrhage: a meta-analysis","volume":"79","author":"Hackam","year":"2012","journal-title":"Neurology"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1330","DOI":"10.1161\/01.STR.0000165928.19135.35","article-title":"Frequency of depression after stroke: a systematic review of observational studies","volume":"36","author":"Hackett","year":"2005","journal-title":"Stroke"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1474","DOI":"10.1007\/s00415-020-10315-6","article-title":"Repetitive transcranial magnetic stimulation for post-stroke depression: a randomised trial with neurophysiological insight","volume":"268","author":"Hordacre","year":"2021","journal-title":"J. Neurol."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1186\/s12883-024-03531-4","article-title":"Efficacy of rTMS for poststroke epilepsy and its effects on patients' cognitive function and depressive status","volume":"24","author":"Hu","year":"2024","journal-title":"BMC Neurol."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1016\/j.biopsych.2003.08.017","article-title":"Repetitive transcranial magnetic stimulation as treatment of poststroke depression: a preliminary study","volume":"55","author":"Jorge","year":"2004","journal-title":"Biol. Psychiatry"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1032","DOI":"10.1001\/jamapsychiatry.2016.1932","article-title":"Incidence of depression after stroke, and associated risk factors and mortality outcomes, in a large cohort of Danish patients","volume":"73","author":"J\u00f8rgensen","year":"2016","journal-title":"JAMA Psychiatry"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1186\/s12883-025-04042-6","article-title":"The effect of transcranial direct current stimulation and inhibitory control training on depression and anxiety among post-stroke individuals","volume":"25","author":"Kazinczi","year":"2025","journal-title":"BMC Neurol."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1036","DOI":"10.1589\/jpts.29.1036","article-title":"The effects of repetitive transcranial magnetic stimulation (rTMS) on depression, visual perception, and activities of daily living in stroke patients","volume":"29","author":"Kim","year":"2017","journal-title":"J. Phys. Ther. Sci."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1097\/PHM.0b013e3181d8a5b1","article-title":"Effect of repetitive transcranial magnetic stimulation on cognition and mood in stroke patients: a double-blind, sham-controlled trial","volume":"89","author":"Kim","year":"2010","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"2150","DOI":"10.1016\/j.clinph.2014.05.021","article-title":"Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS)","volume":"125","author":"Lefaucheur","year":"2014","journal-title":"Clin. Neurophysiol."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"337","DOI":"10.3233\/JAD-240505","article-title":"Effect of repetitive transcranial magnetic stimulation on post-stroke comorbid cognitive impairment and depression: a randomized controlled trial","volume":"101","author":"Li","year":"2024","journal-title":"J. Alzheimer's Dis"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1702","DOI":"10.1016\/j.neubiorev.2013.06.014","article-title":"Modelling non-invasive brain stimulation in cognitive neuroscience","volume":"37","author":"Miniussi","year":"2013","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.genhosppsych.2017.04.001","article-title":"Prevalence and predictors of post-stroke mood disorders: a meta-analysis and meta-regression of depression, anxiety and adjustment disorder","volume":"47","author":"Mitchell","year":"2017","journal-title":"Gen. Hosp. Psychiatry"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"43850","DOI":"10.1038\/s41598-025-28648-5","article-title":"Efficacy and safety of home-based transcranial direct current stimulation (tDCS) on patients with depressive disorders: a systematic review and meta-analysis of randomized clinical trials","volume":"15","author":"Moshfeghinia","year":"2025","journal-title":"Sci. Rep."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"2391","DOI":"10.1001\/jama.299.20.2391","article-title":"Escitalopram and problem-solving therapy for prevention of poststroke depression: a randomized controlled trial","volume":"299","author":"Robinson","year":"2008","journal-title":"JAMA"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1080\/10749357.2023.2165258","article-title":"Feasibility of performing a multi-arm clinical trial examining the novel combination of repetitive transcranial magnetic stimulation and aerobic exercise for post-stroke depression","volume":"30","author":"Ross","year":"2023","journal-title":"Top. Stroke Rehabil."},{"key":"ref30","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/j.jad.2016.12.058","article-title":"Repetitive transcranial magnetic stimulation for the treatment of post-stroke depression: a systematic review and meta-analysis of randomized controlled clinical trials","volume":"211","author":"Shen","year":"2017","journal-title":"J. Affect. Disord."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1016\/j.tics.2008.09.004","article-title":"State-dependency in brain stimulation studies of perception and cognition","volume":"12","author":"Silvanto","year":"2008","journal-title":"Trends Cogn. Sci."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1136\/jnnp-2016-314075","article-title":"Transcranial direct current stimulation for the treatment of post-stroke depression: results from a randomised, sham-controlled, double-blinded trial","volume":"88","author":"Valiengo","year":"2017","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"697","DOI":"10.1186\/s12888-025-07151-1","article-title":"Repetitive transcranial magnetic stimulation for treating post-stroke depression: a systematic review and network meta-analysis","volume":"25","author":"Wang","year":"2025","journal-title":"BMC Psychiatry"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"e40227","DOI":"10.1097\/MD.0000000000040227","article-title":"Clinical study of different frequency transcranial magnetic stimulation combined with paroxetine in the treatment of poststroke depression with insomnia","volume":"103","author":"Xu","year":"2024","journal-title":"Medicine (Baltimore)"},{"key":"ref36","first-page":"11883","article-title":"The effect of fluoxetine combined with repetitive transcranial magnetic stimulation on the psychological emotions and cognitive and neurological functions of acute post-stroke depression patients","volume":"13","author":"Yu","year":"2021","journal-title":"Am. J. Transl. Res."},{"key":"ref37","doi-asserted-by":"publisher","first-page":"e20243847","DOI":"10.47626\/1516-4446-2024-3847","article-title":"Cognitive changes in post-stroke depression patients undergoing treatment with transcranial direct current stimulation (tDCS): an exploratory, ancillary analysis of a randomized, sham-controlled clinical trial","volume":"47","author":"Zan\u00e3o","year":"2025","journal-title":"Braz J Psychiatry"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"626","DOI":"10.5152\/alphapsychiatry.2024.241646","article-title":"Non-invasive brain stimulation progression in post-stroke depression treatment: a systematic review","volume":"25","author":"Zhang","year":"2024","journal-title":"Alpha Psychiatry"},{"key":"ref39","first-page":"9144","article-title":"Effects of low-frequency repetitive transcranial magnetic stimulation combined with nicergoline in the treatment of post-ischemic stroke depression","volume":"13","author":"Zhang","year":"2020","journal-title":"Int. J. Clin. Exp. Med."},{"key":"ref40","doi-asserted-by":"publisher","first-page":"962231","DOI":"10.3389\/fnhum.2022.962231","article-title":"Effect of transcranial magnetic stimulation in combination with citalopram on patients with post-stroke depression","volume":"16","author":"Zhu","year":"2022","journal-title":"Front. Hum. Neurosci."}],"container-title":["Frontiers in Psychology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2026.1870615\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T05:34:51Z","timestamp":1787808891000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2026.1870615\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,27]]},"references-count":40,"alternative-id":["10.3389\/fpsyg.2026.1870615"],"URL":"https:\/\/doi.org\/10.3389\/fpsyg.2026.1870615","relation":{},"ISSN":["1664-1078"],"issn-type":[{"value":"1664-1078","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,27]]},"article-number":"1870615"}}