Adu Medard Kofi, Eboreime Ejemai, Sapara Adegboyega Oyekunbi, Greenshaw Andrew James, Chue Pierre, Agyapong Vincent Israel Opoku
Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta Edmonton Canada.
Ment Illn. 2021 Sep 17;13(1):1-13. doi: 10.1108/MIJ-05-2021-0002. eCollection 2021.
This paper aims to explore the relevant literature available regarding the use of repetitive transcranial magnetic stimulation (rTMS) as a mode of treatment for obsessive-compulsive disorder (OCD); to evaluate the evidence to support the use of rTMS as a treatment option for OCD.
DESIGN/METHODOLOGY/APPROACH: The authors electronically conducted data search in five research databases (MEDLINE, CINAHL, Psych INFO, SCOPUS and EMBASE) using all identified keywords and index terms across all the databases to identify empirical studies and randomized controlled trials. The authors included articles published with randomized control designs, which aimed at the treatment of OCD with rTMS. Only full-text published articles written in English were reviewed. Review articles on treatment for conditions other than OCD were excluded. The Covidence software was used to manage and streamline the review.
Despite the inconsistencies in the published literature, the application of rTMS over the supplementary motor area and the orbitofrontal cortex has proven to be promising in efficacy and tolerability compared with other target regions such as the prefrontal cortex for the treatment of OCD. Despite the diversity in terms of the outcomes and clinical variability of the studies under review, rTMS appears to be a promising treatment intervention for OCD.
RESEARCH LIMITATIONS/IMPLICATIONS: The authors of this scoping review acknowledge several limitations. First, the search strategy considered only studies published in English and the results are up to date as the last day of the electronic data search of December 10, 2020. Though every effort was made to identify all relevant studies for the purposes of this review per the eligibility criteria, the authors still may have missed some relevant studies, especially those published in other languages.
ORIGINALITY/VALUE: This review brought to bare the varying literature on the application of rTMS and what is considered gaps in the knowledge in this area in an attempt to evaluate and provide information on the potential therapeutic effects of rTMS for OCD.
本文旨在探讨关于重复经颅磁刺激(rTMS)作为强迫症(OCD)治疗方式的现有相关文献;评估支持将rTMS用作OCD治疗选择的证据。
设计/方法/途径:作者使用所有数据库中确定的关键词和索引词,在五个研究数据库(MEDLINE、CINAHL、Psych INFO、SCOPUS和EMBASE)中进行电子数据搜索,以识别实证研究和随机对照试验。作者纳入了采用随机对照设计发表的文章,这些文章旨在用rTMS治疗OCD。仅对以英文发表的全文文章进行了综述。排除了关于OCD以外疾病治疗的综述文章。使用Covidence软件来管理和简化综述。
尽管已发表文献存在不一致之处,但与其他靶区(如前额叶皮质)相比,rTMS应用于辅助运动区和眶额皮质在治疗OCD的疗效和耐受性方面已被证明颇具前景。尽管所审查研究的结果和临床变异性存在差异,但rTMS似乎是一种有前景的OCD治疗干预措施。
研究局限性/启示:本范围综述的作者承认存在若干局限性。首先,搜索策略仅考虑以英文发表的研究,且结果截至2020年12月10日电子数据搜索的最后一天。尽管已尽一切努力根据纳入标准识别本综述目的的所有相关研究,但作者仍可能遗漏了一些相关研究,尤其是那些以其他语言发表的研究。
原创性/价值:本综述揭示了关于rTMS应用的不同文献以及该领域知识中被认为的差距,试图评估并提供有关rTMS对OCD潜在治疗效果的信息。