Hauer Larissa, Sellner Johann, Brigo Francesco, Trinka Eugen, Sebastianelli Luca, Saltuari Leopold, Versace Viviana, Höller Yvonne, Nardone Raffaele
Department of Psychiatry, Psychotherapy and Psychosomatic medicine, Christian Doppler Medical Center, 5020 Salzburg, Austria.
Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, 5020 Salzburg, Austria.
J Clin Med. 2019 Mar 27;8(4):416. doi: 10.3390/jcm8040416.
Repetitive transcranial magnetic stimulation (rTMS) may be effective for enhancing cognitive functioning. In this review, we aimed to systematically evaluate the effects of rTMS on attention in psychiatric diseases. In particular, we searched PubMed and Embase to examine the effectiveness of rTMS administered to the dorsolateral prefrontal cortex (DLPFC) on this specific cognitive domain. The search identified 24 articles, 21 of which met inclusion and exclusion criteria. Among them, nine were conducted in patients with depression, four in patients with schizophrenia, three in patients with autism spectrum disorder (ASD), two in patients with attention deficit hyperactivity disorder, one each in patients with Alzheimer's disease and in patients with alcohol or methamphetamine addiction. No evidence for cognitive adverse effects was found in all the included rTMS studies. Several studies showed a significant improvement of attentional function in patients with depression and schizophrenia. The beneficial effects on attention and other executive functions suggest that rTMS has the potential to target core features of ASD. rTMS may influence the attentional networks in alcohol-dependent and other addicted patients. We also reviewed and discussed the studies assessing the effects of rTMS on attention in the healthy population. This review suggests that prefrontal rTMS could exert procognitive effects on attention in patients with many psychiatric disorders.
重复经颅磁刺激（rTMS）可能对增强认知功能有效。在本综述中，我们旨在系统评估rTMS对精神疾病患者注意力的影响。具体而言，我们检索了PubMed和Embase，以研究对背外侧前额叶皮质（DLPFC）进行rTMS治疗对这一特定认知领域的有效性。检索共识别出24篇文章，其中21篇符合纳入和排除标准。其中，9项研究针对抑郁症患者，4项针对精神分裂症患者，3项针对自闭症谱系障碍（ASD）患者，2项针对注意缺陷多动障碍患者，1项针对阿尔茨海默病患者，1项针对酒精或甲基苯丙胺成瘾患者。在所有纳入的rTMS研究中均未发现认知不良反应的证据。多项研究表明，抑郁症和精神分裂症患者的注意力功能有显著改善。对注意力和其他执行功能的有益影响表明，rTMS有可能针对ASD的核心特征。rTMS可能会影响酒精依赖和其他成瘾患者的注意力网络。我们还回顾并讨论了评估rTMS对健康人群注意力影响的研究。本综述表明，前额叶rTMS可能对许多精神疾病患者的注意力产生促认知作用。
