Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, PO59, London, SE5 8AF, UK.
Hadarim Eating Disorder Unit, Shalvata Mental Health Centre, Hod Hasharon, Israel.
Syst Rev. 2021 Mar 11;10(1):76. doi: 10.1186/s13643-021-01627-3.
BACKGROUND: Most psychiatric disorders have their onset in childhood or adolescence, and if not fully treated have the potential for causing life-long psycho-social and physical sequelae. Effective psychotherapeutic and medication treatments exist, but a significant proportion of children and young people do not make a full recovery. Thus, novel, safe, brain-based alternatives or adjuncts to conventional treatments are needed. Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are non-invasive brain stimulation (NIBS) techniques which have shown clinical benefits in adult psychiatric conditions. However, in children and young people their efficacy is not well established. The objective of this study will be to systematically evaluate the evidence on clinical effects of NIBS in children and young people with psychiatric disorders, assessing disorder-specific symptoms, mood and neurocognitive functions. METHODS: We designed and registered a study protocol for a systematic review. We will include randomised and non-randomised controlled trials and observational studies (e.g. cohort, case-control, case series) assessing the effects of NIBS in children and young people (aged ≤ 24 years old) for psychiatric disorders. The primary outcome will be reduction of disorder-specific symptoms. Secondary outcomes will include effects on mood and cognition. A comprehensive search from database inception onwards will be conducted in MEDLINE, EMBASE and PsycINFO. Grey literature will be identified through searching multiple clinical trial registries. Two reviewers will independently screen all citations, full-text articles and abstract data. The methodological quality of the studies will be appraised using appropriate tools. We will provide a narrative synthesis of the evidence and according to heterogeneity will conduct an appropriate meta-analysis. Additional analyses will be conducted to explore the potential sources of heterogeneity. DISCUSSION: This systematic review will provide a broad and comprehensive evaluation of the evidence on clinical effects of NIBS in children and young people with psychiatric disorders. Our findings will be reported according to the PRISMA guidelines and will be of interest to multiple audiences (including patients, researchers, healthcare professionals and policy-makers). Results will be published in a peer-reviewed journal. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019158957.
背景：大多数精神障碍在儿童或青少年时期发病，如果未得到充分治疗，可能会导致终身的心理社会和身体后遗症。虽然有有效的心理治疗和药物治疗方法，但仍有相当一部分儿童和青少年无法完全康复。因此，需要寻找新的、安全的、基于大脑的替代方法或辅助常规治疗方法。重复经颅磁刺激(rTMS)和经颅直流电刺激(tDCS)是两种非侵入性脑刺激(NIBS)技术，已在成人精神疾病中显示出临床益处。然而，其在儿童和青少年中的疗效尚未得到充分证实。本研究的目的将是系统评估 NIBS 在儿童和青少年精神障碍中的临床效果的证据，评估特定疾病症状、情绪和神经认知功能。
方法：我们为这项系统评价设计并注册了一份研究方案。我们将纳入随机和非随机对照试验以及观察性研究(例如队列、病例对照、病例系列)，评估 NIBS 对儿童和青少年(年龄≤24 岁)精神障碍的疗效。主要结局将是特定疾病症状的减轻。次要结局将包括对情绪和认知的影响。我们将从数据库创建之初开始对 MEDLINE、EMBASE 和 PsycINFO 进行全面检索。通过搜索多个临床试验注册处，确定灰色文献。两位评审员将独立筛选所有引用、全文文章和摘要数据。将使用适当的工具评估研究的方法学质量。我们将对证据进行叙述性综合，并根据异质性进行适当的荟萃分析。将进行额外的分析以探索潜在的异质性来源。
讨论：这项系统评价将对 NIBS 在儿童和青少年精神障碍中的临床效果的证据进行广泛而全面的评估。我们的发现将按照 PRISMA 指南报告，将引起多个受众(包括患者、研究人员、医疗保健专业人员和决策者)的兴趣。结果将发表在同行评议的期刊上。
系统评价注册：PROSPERO CRD42019158957。
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