Akademik Veri Yönetim Sistemi
Asian Journal of Psychiatry, cilt.119, 2026 (SCI-Expanded, Scopus)
ObjectiveTo systematically review and meta-analyze randomized controlled trials (RCTs) and non-randomized studies (non-RCTs) evaluating the efficacy of transcranial magnetic stimulation (TMS) for anhedonia in adults with mood disorders.MethodsPubMed, Scopus, and ClinicalTrials.gov were searched through March 2025. Studies were included if they specifically assessed the effects of TMS on anhedonia in adults (≥18 years) with major depressive disorder or bipolar depression. The primary outcome was change in anhedonia severity measured by the Snaith–Hamilton Pleasure Scale (SHAPS), the Temporal Experience of Pleasure Scale (TEPS), and the Dimensional Anhedonia Rating Scale (DARS). Secondary outcome was change in depression severity. Random-effects meta-analyses with Hartung-Knapp adjustment were performed for sham-controlled RCTs.ResultsFourteen studies (eight RCTs, six non-RCTs) were included. Sham-controlled RCTs showed a small but statistically significant improvement in anhedonia favoring active TMS (SMD = 0.27, 95% CI 0.02, 0.52; p = 0.042). Exploratory analyses of studies using TEPS demonstrated a significant effect on anticipatory anhedonia (Hedges’ g = 0.27, 95% CI 0.09, 0.45). No significant effect was observed for depression severity in RCTs (SMD = −0.14, 95% CI −0.45, 0.17; p = 0.30). Non-RCTs reported larger improvements in both anhedonia and depression; however, studies have substantial heterogeneity and are not directly comparable to sham-controlled RCT findings.ConclusionsTMS is associated with a small improvement in anhedonia. The absence of a significant effect on depression severity should be interpreted cautiously and may suggest that anhedonia could represent a partially distinct neuromodulation target; however, this interpretation remains hypothesis-generating given the limited number of studies and statistical power. Unmet needs include the standardization of anhedonia assessment favoring multidimensional scales and powered designs with anhedonia as a primary outcome.