Combination of non-invasive brain stimulation with mindfulness-based interventions for anxiety and depression symptoms: systematic review and meta-analysis of randomized controlled trials.
Anastasia Demina, Benjamin Petit, Vincent Meille, Anne Sauvaget, Florent Lebon, Benoit Trojak
European archives of psychiatry and clinical neuroscience November 17, 2024 DOI: 10.1007/s00406-024-01928-3
Summary
Combining non-invasive brain stimulation (NIBS) with mindfulness-based interventions (MBIs) shows promise for mental health improvement. In a review of 12 trials involving clinical populations, anxiety symptoms improved significantly, with a large effect size of -0.82, indicating strong benefits from this bimodal treatment. Meanwhile, depression symptoms showed a smaller effect size of -0.24, which was not statistically significant. Participants found the NIBS/MBI combination feasible and well-tolerated, suggesting a potential pathway for enhancing neuroplasticity and addressing anxiety and depression effectively.
Abstract
In this article we aimed synthesize all available evidence regarding the effects of non-invasive brain stimulation (NIBS) techniques combined with mindfulness-based interventions (MBIs) on mental health indicators. We performed a systematic review of randomized controlled trials evaluating NIBS/MBIs combinations in clinical populations and a random effects pairwise meta-analysis of studies evaluating anxiety and depression symptoms. After independent trial selection by two authors based on titles/abstracts, and then on full texts, twelve trials were retrieved. There was a large effect size favoring the NIBS/MBIs over the control intervention for anxiety symptoms (Cohen's d = - 0.82 (- 1.35, - 0.30), I2 = 55%, moderate certainty of evidence). As for depression symptoms, there was a small-to-medium effect size that did not reach statistical significance (Cohen's d = - 0.24 (- 0.61, 0.13), I2 = 30%, low certainty of evidence). MBIs/NIBS combination is feasible and well tolerated. There is preliminary evidence for its therapeutic promise. Future studies should inform combination choices by neural correlates of respective interventions and offer patients mindfulness familiarization before implementation of the NIBS/MBIs treatment.Trial registration CRD42022353971.