Ho-ho-ho! Gather ’round, my merry friends, for I have a tale that’s quite the brain teaser, quite literally! In the bustling workshop of mental health, there’s a nifty little gadget called Transcranial Magnetic Stimulation, or TMS for short. It’s like a magical wand for the mind, zapping away the blues of major depressive disorder (MDD) with the flick of a switch. Now, the elves in white coats have been placing this TMS cap over a special spot on the noggin called the left dorsolateral prefrontal cortex, or lDLPFC if you’re short on time.

But here’s the twist in the candy cane: there are three different ways to find this lDLPFC – the ‘5 cm’ method, the F3 method, and the neuro-navigational method, each as unique as a snowflake. And the question that’s got the reindeer scratching their antlers is, which method brings the most cheer to those with MDD?

So, we’re packing our sleigh with a protocol for a systematic review and a network meta-analysis (NMA), a fancy term for figuring out which TMS targeting method tops the nice list. We’ll be checking it twice, searching through databases far and wide, from PubMed to China Science and Technology Journal Database, looking for studies published up to May 2023, in English or Chinese, no less!

We’ll only include the most magical of studies – randomised controlled trials that compare these TMS methods with a sham treatment or with each other. The interventions must include at least 10 sessions of high-frequency TMS, because consistency is key when you’re trying to light up the tree of the mind.

Our primary outcome is the score reduction on various depression rating scales, because we want to see those frowns turn upside down. And we can’t forget about the dropout rate, a secondary outcome that tells us if the treatment is as palatable as a gingerbread cookie.

Using the statistical reindeer Stata, we’ll conduct pairwise meta-analyses and a random-effects NMA, and then we’ll rank these methods with something called the surface under the cumulative ranking curve. It’s like making a list of who’s been naughty or nice, but for TMS methods.

No need to send a letter to the North Pole for ethics approval, as this review is just about gathering existing presents, I mean, data. And once we’ve wrapped up this festive analysis, we’ll submit it for publication so everyone can share in the holiday spirit.

So, keep your stockings hung by the chimney with care, in hopes that the best TMS method soon will be clear! 🎅🎄