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它对快感缺乏和意志缺乏更有效吗?对精神分裂症阴性症状的非侵入性脑刺激干预的系统评价和荟萃分析。

Is it more effective for anhedonia and avolition? A systematic review and meta-analysis of non-invasive brain stimulation interventions for negative symptoms in schizophrenia.

作者信息

Chen Yuying, Li Zhuofeng, Yan Chao, Zou Laiquan

机构信息

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.

出版信息

CNS Neurosci Ther. 2024 Mar;30(3):e14645. doi: 10.1111/cns.14645.


DOI:10.1111/cns.14645
PMID:38432851
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10909625/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62ef/10909625/4ec6b4902e07/CNS-30-e14645-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62ef/10909625/b331ebf5f468/CNS-30-e14645-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62ef/10909625/70865e676e4c/CNS-30-e14645-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62ef/10909625/53125875fe7b/CNS-30-e14645-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62ef/10909625/4ec6b4902e07/CNS-30-e14645-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62ef/10909625/b331ebf5f468/CNS-30-e14645-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62ef/10909625/70865e676e4c/CNS-30-e14645-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62ef/10909625/53125875fe7b/CNS-30-e14645-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62ef/10909625/4ec6b4902e07/CNS-30-e14645-g001.jpg

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引用本文的文献

[1]
Adjunctive Intermittent Theta-Burst Stimulation for Schizophrenia: A Systematic Review and Meta-analysis of Randomized Double-Blind Controlled Studies.

Alpha Psychiatry. 2024-11-1

本文引用的文献

[1]
Delayed improvements in visual memory task performance among chronic schizophrenia patients after high-frequency repetitive transcranial magnetic stimulation.

World J Psychiatry. 2022-9-19

[2]
Assessment of Noninvasive Brain Stimulation Interventions for Negative Symptoms of Schizophrenia: A Systematic Review and Network Meta-analysis.

JAMA Psychiatry. 2022-8-1

[3]
A meta-analytic review of transcranial direct current stimulation (tDCS) on general psychopathology symptoms of schizophrenia; immediate improvement followed by a return to baseline.

Psychiatry Res. 2022-4

[4]
Assessment and Treatment of Negative Symptoms in Schizophrenia-A Regional Perspective.

Front Psychiatry. 2022-2-4

[5]
Intermittent theta burst stimulation of cerebellar vermis enhances fronto-cerebellar resting state functional connectivity in schizophrenia with predominant negative symptoms: A randomized controlled trial.

Schizophr Res. 2021-12

[6]
High frequency repetitive transcranial magnetic stimulation of dorsomedial prefrontal cortex for negative symptoms in patients with schizophrenia: A double-blind, randomized controlled trial.

Psychiatry Res. 2021-5

[7]
Adjuvant High-Definition Transcranial Direct Current Stimulation for Negative Symptoms in Schizophrenia: A Pilot Study.

J ECT. 2021-9-1

[8]
Efficacy of transcranial direct current stimulation in ameliorating negative symptoms and cognitive impairments in schizophrenia: A systematic review and meta-analysis.

Schizophr Res. 2020-10

[9]
Pathophysiology of negative symptom dimensions of schizophrenia - Current developments and implications for treatment.

Neurosci Biobehav Rev. 2020-9

[10]
A randomized, double blind, sham-controlled trial of repetitive transcranial magnetic stimulation (rTMS) in the treatment of negative symptoms in schizophrenia.

Brain Stimul. 2020-2-29

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