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重复经颅磁刺激治疗帕金森病伴抑郁患者的疗效。

The efficacy of repetitive transcranial magnetic stimulation for Parkinson disease patients with depression.

机构信息

Department of Neurology, West China Hospital, Sichuan University, Wai Nan Guo Xue Lane #, Chengdu 610041, Sichuan, China.

出版信息

Int J Neurosci. 2020 Jan;130(1):19-27. doi: 10.1080/00207454.2018.1495632. Epub 2019 Oct 15.

Abstract

To evaluate the efficacy of repetitive transcranial magnetic stimulation for Parkinson disease (PD) patients with depression. A meta-analysis was performed using relevant randomized controlled trials (RCTs) from online databases such as PubMed, Embase, Cochrane Online Library, and Clinicaltrials.gov. Studies were selected according to pre-defined inclusion and exclusion criteria, and the quality of the studies was evaluated using the Jadad Scale. All data were pooled by RevMan 5.2 software for meta-analysis. The review covered 528 articles, and 7 articles with Jadad score ≥4 were included in the analysis. The meta-analysis showed that, compared to sham repetitive transcranial magnetic stimulation (sham-rTMS), repetitive transcranial magnetic stimulation (rTMS) over dorsolateral prefrontal cortex (DLPFC) improved depression, but that there was no significant difference in depression improvement between rTMS and selective serotonin reuptake inhibitor (SSRI) treatment. In contrast, rTMS over DLPFC did not improve motor function compared to sham-rTMS or SSRI, and the studies that included neurocognitive measures showed no significant difference between rTMS and sham-rTMS. This meta-analysis provides evidence that rTMS over DLPFC can improve depression similar to SSRI treatment, has no effect on the motor function and cognition of PD patients with depression.

摘要

评价重复经颅磁刺激治疗帕金森病(PD)伴抑郁患者的疗效。通过对 PubMed、Embase、 Cochrane Online Library 和 Clinicaltrials.gov 等在线数据库中相关的随机对照试验(RCT)进行荟萃分析。根据预先设定的纳入和排除标准选择研究,并使用 Jadad 量表评估研究质量。使用 RevMan 5.2 软件对所有数据进行荟萃分析。综述涵盖了 528 篇文章,有 7 篇 Jadad 评分≥4 的文章纳入分析。荟萃分析表明,与假刺激重复经颅磁刺激(假 rTMS)相比,重复经颅磁刺激(rTMS)刺激背外侧前额叶(DLPFC)可改善抑郁症状,但 rTMS 与选择性 5-羟色胺再摄取抑制剂(SSRIs)治疗在改善抑郁方面无显著差异。相比之下,rTMS 刺激 DLPFC 与假 rTMS 或 SSRIs 相比并未改善运动功能,纳入神经认知测量的研究表明 rTMS 与假 rTMS 之间无显著差异。这项荟萃分析提供了证据表明,rTMS 刺激 DLPFC 可以改善抑郁症状,与 SSRIs 治疗效果相当,对 PD 伴抑郁患者的运动功能和认知无影响。

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