Blay Martin, Adam Ondine, Bation Rémy, Galvao Filipe, Brunelin Jérôme, Mondino Marine
Centre Hospitalier le Vinatier, F-69500 Bron, France.
Université Lyon 1, Lyon University, F-69100 Villeurbanne, France.
J Clin Med. 2021 Dec 22;11(1):40. doi: 10.3390/jcm11010040.
Patients with schizophrenia are often unaware of their condition and the consequences of their illness. This lack of insight results in impaired functioning, treatment non-adherence and poor prognosis. Here, we aimed to investigate the effects of non-invasive brain stimulation (NIBS) on two forms of insight, clinical and cognitive, in patients with schizophrenia. We conducted a systematic review of the literature registered in the PROSPERO database (CRD42020220323) according to PRISMA guidelines. The literature search was conducted in Medline and Web of Science databases based on studies published up until October 2020 that included pre-NIBS and post-NIBS measurements of clinical and/or cognitive insight in adults with schizophrenia. A total of 14 studies were finally included, and their methodological quality was assessed by using the QualSyst tool. Despite the lack of well-conducted large randomized-controlled studies using insight as the primary outcome, the available findings provide preliminary evidence that NIBS can improve clinical insight in patients with schizophrenia, with a majority of studies using transcranial direct current stimulation with a left frontotemporal montage. Further studies should investigate the effect of NIBS on insight as a primary outcome and how these effects on insight could translate into clinical and functional benefits in patients with schizophrenia.
精神分裂症患者往往意识不到自己的病情及其疾病后果。这种洞察力的缺乏会导致功能受损、治疗依从性差和预后不良。在此，我们旨在研究非侵入性脑刺激（NIBS）对精神分裂症患者两种形式的洞察力，即临床洞察力和认知洞察力的影响。我们根据PRISMA指南对PROSPERO数据库（CRD42020220323）中注册的文献进行了系统综述。基于截至2020年10月发表的研究，在Medline和Web of Science数据库中进行文献检索，这些研究包括对成年精神分裂症患者进行NIBS治疗前和治疗后的临床和/或认知洞察力测量。最终共纳入14项研究，并使用QualSyst工具评估其方法学质量。尽管缺乏以洞察力为主要结局的高质量大型随机对照研究，但现有研究结果提供了初步证据，表明NIBS可以改善精神分裂症患者的临床洞察力，大多数研究使用左额颞部组合的经颅直流电刺激。进一步的研究应调查NIBS作为主要结局对洞察力的影响，以及这些对洞察力的影响如何转化为精神分裂症患者的临床和功能益处。
