Effects of noninvasive brain stimulation in the treatment of poststroke depression: an overview of systematic reviews

BackgroundIn recent years, although numerous meta-analyses/systematic reviews (MAs/SRs) have explored the therapeutic effect of noninvasive brain stimulation (NIBS) on poststroke depression, the reliability and quality of its clinical evidence remain uncertain. Therefore, this study aims to conduct an overview of systematic reviews to evaluate the effectiveness and safety of NIBS for PSD, thereby providing evidence-based support for clinical decision-making.MethodsA comprehensive search of multiple databases, including PubMed, EMBASE, the Cochrane Library, Web of Science, CNKI, VIP, Wan Fang, and CBM, was conducted to identify systematic reviews and meta-analyses of NIBS for PSD. Following the literature screen and data extraction, the quality of the included studies was assessed using the PRISMA statement for reporting quality, the AMSTAR-2 tool for methodological quality, and the GRADE system for evidence quality. We extracted the main outcome indicators of depressive symptoms and the secondary outcome indicators of neurological function, cognitive function, daily living ability, anxiety symptoms, clinical efficiency and adverse reactions for analysis.ResultsA total of 20 MAs/SRs were included. According to the PRISMA statement, 6 (30%) reports were relatively complete, 13 (65%) had problems, and 1 (5%) had serious information deficiencies. The results of the AMSTAR-2 evaluation revealed that 3 articles (15%) were of moderate quality, 5 (25%) were of low quality, and 12 (60%) were of critically low quality. Thus, the overall quality was not high. The GRADE evaluation revealed that a total of 66 evidence bodies were included: 9 (13.6%) had moderate evidence, 15 (22.8%) had low-level evidence, and 42 (63.6%) had very low-level evidence, and no high-quality outcome indicator was identified.ConclusionThe included studies revealed that NIBS is an effective and safe treatment for PSD. However, because the methodology and results of the MAs/SRs were generally not of high quality, the reliability of the conclusions is limited to a certain extent. Future research should focus on conducting more high-quality, large-sample, multicenter follow-up studies to further verify the value of applying NIBS in PSD treatment.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD42025633044, identifier CRD42025633044.