Cheng Pak Wing Calvin, Louie Larissa Lok Chi, Wong Yiu Lung, Wong Sau Man Corine, Leung Wing Yin, Nitsche Michael A, Chan Wai Chi
Department of Psychiatry, The University of Hong Kong, Hong Kong.
Department of Psychiatry, The University of Hong Kong, Hong Kong.
Asian J Psychiatr. 2020 Oct;53:102392. doi: 10.1016/j.ajp.2020.102392. Epub 2020 Sep 5.
This systematic review and meta-analysis aims to examine the effects of transcranial direct current stimulation (tDCS) on clinical symptoms in schizophrenia.
A literature search was performed for articles published in English using the following databases: MEDLINE, EMBASE, PsycINFO, INSPEC, the Cumulative Index to Nursing & Allied Health Literature Plus (CINAHL Plus), AMED, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov, EU Clinical Trials Register, and WHO International Clinical Trials Registry Platform, from their inception to October 2019. The primary outcome variables were the clinical symptoms of schizophrenia including positive symptoms, negative symptoms, and auditory hallucinations.
16 randomized controlled trials (RCTs) were included in the meta-analysis, with a sample of 326 patients with active and with 310 sham tDCS. Active tDCS was found to be more effective in improving positive symptoms [standardized mean difference (SMD) = 0.17; 95 % confidence interval (CI) 0.001 to 0.33], negative symptoms [SMD = 0.43, 95 % CI 0.11, 0.75] and auditory hallucinations [SMD = 0.36 95 % CI 0.02, 0.70]. Subgroup analyses showed better results in cases of pure diagnosis of schizophrenia, higher frequency and more sessions of stimulation.
tDCS was effective in improving positive symptoms, negative symptoms and auditory hallucination in schizophrenia. It therefore has potential as a safe and well-tolerated adjunctive intervention for schizophrenia.
本系统评价和荟萃分析旨在研究经颅直流电刺激（tDCS）对精神分裂症临床症状的影响。
使用以下英文数据库检索自建库至2019年10月发表的文章：医学文献数据库（MEDLINE）、荷兰医学文摘数据库（EMBASE）、心理学文摘数据库（PsycINFO）、科学文摘数据库（INSPEC）、护理学与健康相关文献累积索引数据库（CINAHL Plus）、联合和补充医学数据库（AMED）、Cochrane系统评价数据库（CENTRAL）、美国国立医学图书馆临床试验数据库（ClinicalTrials.gov）、欧盟临床试验注册库、世界卫生组织国际临床试验注册平台。主要结局变量为精神分裂症的临床症状，包括阳性症状、阴性症状和幻听。
荟萃分析纳入了16项随机对照试验（RCT），样本包括326例接受活性tDCS治疗的患者和310例接受假tDCS治疗的患者。发现活性tDCS在改善阳性症状[标准化均数差（SMD）=0.17；95%置信区间（CI）0.001至0.33]、阴性症状[SMD = 0.43，95%CI 0.11，0.75]和幻听[SMD = 0.36，95%CI 0.02，0.70]方面更有效。亚组分析显示，在单纯精神分裂症诊断、较高刺激频率和较多刺激疗程的情况下，效果更佳。
tDCS对改善精神分裂症的阳性症状、阴性症状和幻听有效。因此，它有潜力作为一种安全且耐受性良好的精神分裂症辅助干预措施。
