非侵入性脑刺激治疗焦虑障碍的疗效：假刺激或行为对照研究的荟萃分析。
Effectiveness of noninvasive brain stimulation in the treatment of anxiety disorders: a meta-analysis of sham or behaviour-controlled studies.
机构信息
From the Department of Psychology, University of Milano Bicocca, Milan, Italy (Vergallito, Pisoni, Punzi, Romero Lauro); the Neuromi, Milan, Italy (Vergallito, Gallucci, Pisoni, Romero Lauro); the Department of Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy (Gallucci); the Studi Cognitivi, Milan, Italy (Caselli, Ruggiero, Sassaroli); and the Faculty of Psychology, Sigmund Freud University, Milan, Italy (Caseli, Ruggiero, Sassaroli).
From the Department of Psychology, University of Milano Bicocca, Milan, Italy (Vergallito, Pisoni, Punzi, Romero Lauro); the Neuromi, Milan, Italy (Vergallito, Gallucci, Pisoni, Romero Lauro); the Department of Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy (Gallucci); the Studi Cognitivi, Milan, Italy (Caselli, Ruggiero, Sassaroli); and the Faculty of Psychology, Sigmund Freud University, Milan, Italy (Caseli, Ruggiero, Sassaroli)
出版信息
J Psychiatry Neurosci. 2021 Nov 9;46(6):E592-E614. doi: 10.1503/jpn.210050. Print 2021 Nov-Dec.
BACKGROUND
The possibility of using noninvasive brain stimulation to treat mental disorders has received considerable attention recently. Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are considered to be effective treatments for depressive symptoms. However, no treatment recommendation is currently available for anxiety disorders, suggesting that evidence is still limited. We conducted a systematic review of the literature and a quantitative analysis of the effectiveness of rTMS and tDCS in the treatment of anxiety disorders.
METHODS
Following PRISMA guidelines, we screened 3 electronic databases up to the end of February 2020 for English-language, peer-reviewed articles that included the following: a clinical sample of patients with an anxiety disorder, the use of a noninvasive brain stimulation technique, the inclusion of a control condition, and pre/post scores on a validated questionnaire that measured symptoms of anxiety.
RESULTS
Eleven papers met the inclusion criteria, comprising 154 participants assigned to a stimulation condition and 164 to a sham or control group. We calculated Hedge's for scores on disorder-specific and general anxiety questionnaires before and after treatment to determine effect size, and we conducted 2 independent random-effects meta-analyses. Considering the well-known comorbidity between anxiety and depression, we ran a third meta-analysis analyzing outcomes for depression scores. Results showed a significant effect of noninvasive brain stimulation in reducing scores on disorder-specific and general anxiety questionnaires, as well as depressive symptoms, in the real stimulation compared to the control condition.
LIMITATIONS
Few studies met the inclusion criteria; more evidence is needed to strengthen conclusions about the effectiveness of noninvasive brain stimulation in the treatment of anxiety disorders.
CONCLUSION
Our findings showed that noninvasive brain stimulation reduced anxiety and depression scores compared to control conditions, suggesting that it can alleviate clinical symptoms in patients with anxiety disorders.
背景
最近，使用非侵入性脑刺激治疗精神障碍的可能性引起了相当大的关注。重复经颅磁刺激（rTMS）和经颅直流电刺激（tDCS）被认为是治疗抑郁症状的有效方法。然而，目前尚无焦虑症的治疗建议，这表明证据仍然有限。我们对文献进行了系统回顾和 rTMS 和 tDCS 治疗焦虑症的有效性的定量分析。
方法
根据 PRISMA 指南，我们筛选了截至 2020 年 2 月底的 3 个电子数据库，以获取包含以下内容的英文同行评审文章：患有焦虑症的临床样本、使用非侵入性脑刺激技术、包括对照条件以及用于测量焦虑症状的有效问卷的治疗前后的评分。
结果
符合纳入标准的 11 篇论文共纳入 154 名接受刺激治疗的患者和 164 名接受假刺激或对照组的患者。我们计算了治疗前后特定于疾病和一般焦虑问卷的分数的 Hedge's ，以确定效应大小，并进行了 2 项独立的随机效应荟萃分析。考虑到焦虑和抑郁之间众所周知的共病性，我们进行了第三次荟萃分析，分析了抑郁分数的结果。结果表明，与对照组相比，真实刺激可显著降低特定于疾病和一般焦虑问卷以及抑郁症状的分数。
局限性
符合纳入标准的研究很少；需要更多的证据来加强关于非侵入性脑刺激治疗焦虑症的有效性的结论。
结论
我们的研究结果表明，与对照组相比，非侵入性脑刺激可降低焦虑和抑郁评分，表明它可以缓解焦虑症患者的临床症状。
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