Chen Yuying, Li Zhuofeng, Yan Chao, Zou Laiquan
Chemical Senses and Mental Health Lab, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China.
Key Laboratory of Brain Functional Genomics (MOE&STCSM), School of Psychology and Cognitive Science, East China Normal University, Shanghai, China.
CNS Neurosci Ther. 2024 Mar;30(3):e14645. doi: 10.1111/cns.14645.
BACKGROUND: Noninvasive brain stimulation (NIBS) techniques are a promising tool for treating the negative symptoms of schizophrenia. Growing evidence suggests that different dimensions of negative symptoms have partly distinct underlying pathophysiological mechanisms. Previous randomized controlled trials (RCTs) have shown inconsistent impacts of NIBS across dimensions. OBJECTIVE: This systematic review and meta-analysis evaluated the effects of NIBS on general negative symptoms, and on specific domains, including blunted affect, alogia, asociality, anhedonia, and avolition. DATA SOURCES: PubMed, Web of Science, Embase, Cochrane CENTRAL, PsycINFO, OpenGrey, and Clinicaltrials.gov from the first date available to October, 2023. RESULTS: Among 1049 studies, we identified eight high-quality RCTs. NIBS significantly affects general negative symptoms (SMD = -0.54, 95% CI [-0.88, -0.21]) and all five domains (SMD = -0.32 to -0.63). Among dimensions, better effects have been shown for improvement of avolition (SMD = -0.47, 95% CI [-0.81, -0.13]) and anhedonia (SMD = -0.63, 95% CI [-0.98, -0.28]). Subgroup analyses of studies that applied once daily stimulation or >10 sessions showed significantly reduced negative symptom severity. CONCLUSION: NIBS exerts distinct effects across multiple dimensions of negative symptom, with treatment effects related to stimulation frequency and total sessions. These results need to be confirmed in dedicated studies.
背景:无创脑刺激(NIBS)技术是治疗精神分裂症阴性症状的一种有前景的工具。越来越多的证据表明,阴性症状的不同维度具有部分不同的潜在病理生理机制。先前的随机对照试验(RCT)显示,NIBS在不同维度上的影响不一致。 目的:本系统评价和荟萃分析评估了NIBS对一般阴性症状以及对包括情感迟钝、言语贫乏、社交退缩、快感缺失和意志缺乏在内的特定领域的影响。 数据来源:从可获取的第一天到2023年10月的PubMed、科学网、Embase、Cochrane CENTRAL、PsycINFO、OpenGrey和Clinicaltrials.gov。 结果:在1049项研究中,我们确定了8项高质量的RCT。NIBS显著影响一般阴性症状(标准化均数差[SMD]=-0.54,95%可信区间[-0.88,-0.21])和所有五个领域(SMD=-0.32至-0.63)。在各个维度中,意志缺乏(SMD=-0.47,95%可信区间[-0.81,-0.13])和快感缺失(SMD=-0.63,95%可信区间[-0.98,-0.28])的改善效果更好。对每日刺激一次或超过10次的研究进行亚组分析显示,阴性症状严重程度显著降低。 结论:NIBS在阴性症状的多个维度上发挥不同的作用,治疗效果与刺激频率和总疗程有关。这些结果需要在专门的研究中得到证实。
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