精神障碍经颅磁刺激的皮质抑制和兴奋性的荟萃分析。
A meta-analysis of cortical inhibition and excitability using transcranial magnetic stimulation in psychiatric disorders.
机构信息
Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada.
出版信息
Clin Neurophysiol. 2013 Jul;124(7):1309-20. doi: 10.1016/j.clinph.2013.01.014. Epub 2013 Feb 26.
OBJECTIVE
To evaluate transcranial magnetic stimulation (TMS) measures of inhibition and excitation in obsessive-compulsive disorder (OCD), major depressive disorder (MDD) and schizophrenia (SCZ).
METHODS
Paradigms included: short-interval cortical inhibition (SICI), cortical silent period (CSP), resting motor threshold, intracortical facilitation, and motor evoked potential amplitude. A literature search was performed using PubMed, Ovid Medline, Embase Psychiatry and PsycINFO 1990 through April 2012.
RESULTS
A significant Hedge's g was found for decreased SICI (g=0.572, 95% confidence interval [0.179, 0.966], p=0.004), enhanced intracortical facilitation (g=0.446, 95% confidence interval [0.042, 0.849], p=0.030) and decreased CSP (g=-0.466, 95% confidence interval [-0.881, -0.052], p=0.027) within the OCD population. For MDD, significant effect sizes were demonstrated for decreased SICI (g=0.641, 95% confidence interval [0.384, 0.898], p=0.000) and shortened CSP (g=-1.232, 95% confidence interval [-1.530, -0.933], p=0.000). In SCZ, a significant Hedge's g was shown for decreased SICI (g=0.476, 95% confidence interval [0.331, 0.620], p=0.000).
CONCLUSION
Inhibitory deficits are a ubiquitous finding across OCD, MDD, SCZ and enhancement of intracortical facilitation is specific to OCD.
SIGNIFICANCE
Provides a clear platform from which diagnostic procedures can be developed.
目的
评估强迫症（OCD）、重度抑郁症（MDD）和精神分裂症（SCZ）患者的经颅磁刺激（TMS）的抑制和兴奋测量值。
方法
研究方案包括：短程皮质抑制（SICI）、皮质静息期（CSP）、静息运动阈值、皮质内易化和运动诱发电位振幅。通过 PubMed、Ovid Medline、Embase Psychiatry 和 PsycINFO 1990 年至 2012 年 4 月进行文献检索。
结果
在 OCD 患者中，发现 SICI 降低（g=0.572，95%置信区间 [0.179, 0.966]，p=0.004）、皮质内易化增强（g=0.446，95%置信区间 [0.042, 0.849]，p=0.030）和 CSP 降低（g=-0.466，95%置信区间 [-0.881, -0.052]，p=0.027）的 Hedge's g 有显著差异。对于 MDD，SICI 降低（g=0.641，95%置信区间 [0.384, 0.898]，p=0.000）和 CSP 缩短（g=-1.232，95%置信区间 [-1.530, -0.933]，p=0.000）的效应大小具有显著差异。在 SCZ 中，SICI 降低（g=0.476，95%置信区间 [0.331, 0.620]，p=0.000）的 Hedge's g 有显著差异。
结论
抑制缺陷是 OCD、MDD、SCZ 患者的普遍发现，而皮质内易化的增强是 OCD 特有的。
意义
为诊断程序的开发提供了明确的平台。
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