电休克治疗对抑郁症患者认知功能的影响：一项系统评价和荟萃分析的方案
Effects of electroconvulsive therapy on cognitive functioning in patients with depression: protocol for a systematic review and meta-analysis.
作者信息
Oremus Carolina, Oremus Mark, McNeely Heather, Losier Bruno, Parlar Melissa, King Matthew, Hasey Gary, Fervaha Gagan, Graham Allyson C, Gregory Caitlin, Hanford Lindsay, Nazarov Anthony, Restivo Maria, Tatham Erica, Truong Wanda, Hall Geoffrey B C, Lanius Ruth, McKinnon Margaret
机构信息
McMaster Integrative Neuroscience Discovery and Study (MINDS) & Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.
School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
出版信息
BMJ Open. 2015 Mar 11;5(3):e006966. doi: 10.1136/bmjopen-2014-006966.
INTRODUCTION
Depression is the leading cause of disability worldwide, affecting approximately 350 million people. Evidence indicates that only 60-70% of persons with major depressive disorder who tolerate antidepressants respond to first-line drug treatment; the remainder become treatment resistant. Electroconvulsive therapy (ECT) is considered an effective therapy in persons with treatment-resistant depression. The use of ECT is controversial due to concerns about temporary cognitive impairment in the acute post-treatment period. We will conduct a meta-analysis to examine the effects of ECT on cognition in persons with depression.
METHODS
This systematic review and meta-analysis has been registered with PROSPERO (registration number: CRD42014009100). We developed our methods following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. We are searching MEDLINE, PsychINFO, EMBASE, CINAHL and Cochrane from the date of database inception to the end of October 2014. We are also searching the reference lists of published reviews and evidence reports for additional citations. Comparative studies (randomised controlled trials, cohort and case-control) published in English will be included in the meta-analysis. Three clinical neuropsychologists will group the cognitive tests in each included article into a set of mutually exclusive cognitive subdomains. The risk of bias of randomised controlled trials will be assessed using the Jadad scale. We will supplement the Jadad scale with additional questions based on the Cochrane risk of bias tool. The risk of bias of cohort and case-control studies will be assessed using the Newcastle-Ottawa Scale. We will employ the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) to assess the strength of evidence.
STATISTICAL ANALYSIS
Separate meta-analyses will be conducted for each ECT treatment modality and cognitive subdomain using Comprehensive Meta-Analysis V.2.0.
引言
抑郁症是全球致残的主要原因，影响着约3.5亿人。有证据表明，在耐受抗抑郁药的重度抑郁症患者中，只有60 - 70%对一线药物治疗有反应；其余患者则产生治疗抵抗。电休克疗法（ECT）被认为是治疗抵抗性抑郁症患者的一种有效疗法。由于担心治疗后急性期会出现暂时的认知障碍，ECT的使用存在争议。我们将进行一项荟萃分析，以研究ECT对抑郁症患者认知的影响。
方法
本系统评价和荟萃分析已在国际前瞻性系统评价注册库（PROSPERO）注册（注册号：CRD42014009100）。我们按照系统评价和荟萃分析的首选报告项目（PRISMA）声明制定了方法。我们将从数据库建立之日至2014年10月底检索MEDLINE、PsychINFO、EMBASE、CINAHL和Cochrane数据库。我们还将检索已发表综述和证据报告的参考文献列表以获取更多引用文献。以英文发表的比较研究（随机对照试验、队列研究和病例对照研究）将纳入荟萃分析。三位临床神经心理学家将把每篇纳入文章中的认知测试分组为一组相互排斥的认知子领域。随机对照试验的偏倚风险将使用Jadad量表进行评估。我们将根据Cochrane偏倚风险工具用额外问题补充Jadad量表。队列研究和病例对照研究的偏倚风险将使用纽卡斯尔 - 渥太华量表进行评估。我们将采用推荐分级的评估、制定和评价（GRADE）来评估证据的强度。
统计分析
将使用Comprehensive Meta - Analysis V.2.0对每种ECT治疗方式和认知子领域进行单独的荟萃分析。
Zotero 插件