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使用非侵入性脑刺激技术来减轻体重和减少食物渴望:系统评价和荟萃分析。

The use of non-invasive brain stimulation techniques to reduce body weight and food cravings: A systematic review and meta-analysis.

机构信息

Clinical, Metabolic and Molecular Physiology, MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, National Institute for Health Research Nottingham Biomedical Research Centre, University of Nottingham, Royal Derby Hospital, Nottingham, UK.

East Midlands Bariatric Metabolic Institute, Royal Derby Hospital, Derby, UK.

出版信息

Clin Obes. 2023 Dec;13(6):e12611. doi: 10.1111/cob.12611. Epub 2023 Aug 14.

Abstract

Several studies demonstrated non-invasive brain stimulation (NIBS) techniques such as transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS) are safe and simple techniques that can reduce body weight, food cravings, and food consumption in patients with obesity. However, a systematic to evaluate the efficacy of active NIBS versus sham stimulation in reducing body weight and food cravings in patients with obesity is not available. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) using PubMed, Embase, MEDLINE, and Cochrane Central Register of Control Trial between January 1990 and February 2022. Mean differences (MDs) for continuous outcome variables with 95% confidence intervals (95% CIs) were used to examine the effects of NIBS on body weight and body mass index (BMI), whereas the hedges's g test was used to measure the effects on food craving. Nineteen RCTs involving 571 participants were included in this study. Active neurostimulation (TMS and tDCS) was significantly more likely than sham stimulation to reduce body weight (TMS: -3.29 kg, 95% CI [-5.32, -1.26]; I  = 48%; p < .001; tDCS: -0.82 kg, 95% CI [-1.01, -0.62]; I  = 0.0%; p = .00) and BMI (TMS: -0.74, 95% CI [-1.17, -0.31]; I  = 0% p = .00; tDCS: MD = -0.55, 95% CI [-2.32, 1.21]; I  = 0% p = .54) as well as food cravings (TMS: g = -0.91, 95% CI [-1.68, -0.14]; I  = 88 p = .00; tDCS: g = -0.32, 95% CI [-0.62, -0.02]; p = .04). Compared with sham stimulation, our findings indicate that active NIBS can significantly help to reduce body weight and food cravings. Hence, these novel techniques may be used as primary or adjunct tools in treating patients with obesity.

摘要

一些研究表明,非侵入性脑刺激(NIBS)技术,如经颅直流电刺激(tDCS)和经颅磁刺激(TMS),是安全且简单的技术,可以减轻肥胖患者的体重、食欲和食物摄入量。然而,目前尚无系统评估主动 NIBS 与假刺激在减轻肥胖患者体重和食欲方面的疗效。我们对 1990 年 1 月至 2022 年 2 月期间在 PubMed、Embase、MEDLINE 和 Cochrane 对照试验中心注册库中进行的随机对照试验(RCTs)进行了系统评价和荟萃分析。使用 95%置信区间(95%CI)的均值差(MDs)来检查 NIBS 对体重和体重指数(BMI)的影响,而 hedges'g 检验用于衡量对食物渴望的影响。本研究共纳入 19 项 RCTs,涉及 571 名参与者。与假刺激相比,主动神经刺激(TMS 和 tDCS)更有可能降低体重(TMS:-3.29kg,95%CI [-5.32,-1.26];I = 48%;p <.001;tDCS:-0.82kg,95%CI [-1.01,-0.62];I = 0%;p =.00)和 BMI(TMS:-0.74,95%CI [-1.17,-0.31];I = 0%;p =.00)以及食物渴望(TMS:g = -0.91,95%CI [-1.68,-0.14];I = 88%;p =.00;tDCS:g = -0.32,95%CI [-0.62,-0.02];p =.04)。与假刺激相比,我们的研究结果表明,主动 NIBS 可以显著帮助减轻体重和食物渴望。因此,这些新技术可能作为肥胖患者治疗的主要或辅助工具。

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