{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T23:44:39Z","timestamp":1789688679781,"version":"4.0.1"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005199","name":"Chinese Medicine Research Program of Zhejiang Province","doi-asserted-by":"publisher","award":["2026ZL0417"],"award-info":[{"award-number":["2026ZL0417"]}],"id":[{"id":"10.13039\/501100005199","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Major depressive disorder (MDD) necessitates treatments that balance efficacy with tolerability. Electroconvulsive therapy (ECT) is highly effective but limited by cognitive side effects. Magnetic seizure therapy (MST), a more focal convulsive therapy, may offer a superior safety profile. This systematic review and meta-analysis directly compares the efficacy and cognitive safety of MST and ECT for MDD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We systematically searched PubMed, Embase, Cochrane CENTRAL, Web of Science, WanFang, and CNKI (inception to Nov 2025) for randomized and non-randomized controlled studies comparing MST and ECT in adults with MDD. Primary outcomes were antidepressant response and depression score changes. Secondary outcomes included cognitive function, reorientation time, and adverse events. Pooled effect estimates (RR, SMD, MD, OR) with 95% CIs were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>13 studies (N\u00a0=\u00a0607 participants) were included. MST and ECT demonstrated comparable clinical response (RR\u00a0=\u00a01.10, 95% CI: 0.94-1.27) and remission (RR\u00a0=\u00a01.04, 95% CI: 0.72-1.50) rates. Post-sensitivity analysis favored ECT for depression score change (SMD\u00a0=\u00a00.36, p=0.0001). MST was superior in preserving cognitive function (SMD\u00a0=\u00a01.19, p=0.005), enabling faster reorientation (MD=-16.72 min, p&amp;lt;0.00001), and reducing overall adverse event risk (OR\u00a0=\u00a00.23, p&amp;lt;0.00001), notably for memory loss, headache, and muscle pain. Seizure durations were shorter with MST.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>While MST and ECT had comparable response and remission rates, sensitivity analysis of depression score changes suggested potential superiority of ECT, warranting cautious interpretation. MST provided significantly better cognitive safety and tolerability, including fewer cognitive adverse events and faster reorientation. These findings support MST as a valuable alternative for MDD patients, especially when cognitive side effects are a primary concern.<\/jats:p>\n                    <jats:p>This systematic review and meta-analysis was conducted and reported in strict accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines (23).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic Review Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420261277041<\/jats:ext-link>\n                      , identifier CRD420261277041.\n                    <\/jats:p>\n                  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China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiaoqiao","family":"Wang","sequence":"additional","affiliation":[{"name":"Rehabilitation Assessment and Treatment Center, The Third Affiliated Hospital of Zhejiang Chinese Medical University","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Li","sequence":"additional","affiliation":[{"name":"Affiliated Mental Health Center & Hangzhou Seventh People\u2019s Hospital, Zhejiang University School of Medicine","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1017\/s0033291712001511","article-title":"Global variation in the prevalence and incidence of major depressive disorder: a systematic review of the epidemiological 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