基于正念的干预措施对多发性硬化症患者认知的影响：随机对照试验的系统评价和荟萃分析
Effects of mindfulness-based interventions on cognition in people with multiple sclerosis: a systematic review and meta-analysis of randomized controlled trials.
作者信息
Komar Alyssa, Dickson Kirsty, Alavinia Mohammad, Bruno Tania, Bayley Mark, Feinstein Anthony, Scandiffio Jillian, Simpson Robert
机构信息
Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, ON, Canada.
NHS Lothian, Edinburgh, Scotland, United Kingdom.
出版信息
Front Psychiatry. 2024 Jul 12;15:1339851. doi: 10.3389/fpsyt.2024.1339851. eCollection 2024.
INTRODUCTION
Cognitive impairment affects up to 65% of people with multiple sclerosis (PwMS), undermining functional independence and quality of life. The objective of this study is to synthesize existing randomized controlled trial (RCT) evidence on the effects of Mindfulness-based interventions (MBIs) on cognitive function in PwMS.
METHODS
A systematic literature search was conducted to identify RCTs assessing MBIs effects on cognitive functioning in PwMS. Using pre-defined criteria, two independent reviewers screened titles, abstracts, and extracted data from included studies. Meta-analysis was performed, where possible, using a random effects model. Narrative synthesis was undertaken. Preferred Reporting Items for Systematic Reviews and Meta-analysis guidance was followed. PROSPERO_ID:(CRD42021286429).
RESULTS
Twelve eligible RCTs were identified, n=700 PwMS. MBIs included both standardized and tailored interventions, in-person and virtually. A variety of measures of cognitive functioning were reported. Five studies (n=254 PwMS) were included in meta-analysis; pooled results suggested MBIs effectively improved scores on the Paced Auditory Serial Addition Test (PASAT)-2 (SMD=0.38; 95% CI 0.06-0.71; I2 63%; p=0.02), whereas improvements were of borderline significance on the PASAT-3 (SMD=0.32; 95% CI -0.01-0.64; I2 65%; p=0.06), and, although trending to positive, were statistically insignificant on the Perceived Deficits Questionnaire (SMD=0.34; 95 CI -0.05-0.74; I2 0%; p=0.09) and Symbol Digits Modality Test (SMD=0.25; 95% CI -0.15-0.66; I2 0%; p=0.21).
CONCLUSION
Preliminary findings in meta-analysis are inconsistent but suggest potential benefits from MBI training on cognitive functioning in PwMS. High quality RCTs are necessary to test more definitively the impact of MBIs on cognitive functioning in PwMS.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO, identifier CRD42021286429.
引言
认知障碍影响多达65%的多发性硬化症患者（PwMS），损害其功能独立性和生活质量。本研究的目的是综合现有关于基于正念的干预措施（MBIs）对PwMS认知功能影响的随机对照试验（RCT）证据。
方法
进行系统的文献检索，以确定评估MBIs对PwMS认知功能影响的RCT。使用预先定义的标准，两名独立评审员筛选标题、摘要，并从纳入研究中提取数据。尽可能使用随机效应模型进行荟萃分析。进行叙述性综合分析。遵循系统评价和荟萃分析的首选报告项目指南。PROSPERO_ID：（CRD42021286429）。
结果
确定了12项符合条件的RCT，n = 700名PwMS患者。MBIs包括标准化和量身定制的干预措施，包括面对面和虚拟干预。报告了多种认知功能测量方法。五项研究（n = 254名PwMS患者）纳入荟萃分析；汇总结果表明，MBIs有效提高了节奏性听觉连续加法测验（PASAT）-2的得分（标准化均数差[SMD]=0.38；95%置信区间[CI]0.06 - 0.71；I² 63%；p = 0.02），而在PASAT-3上的改善具有临界显著性（SMD = 0.32；95% CI -0.01 - 0.64；I² 65%；p = 0.06），并且，尽管有正向趋势，但在感知缺陷问卷（SMD = 0.34；95% CI -0.05 - 0.74；I² 0%；p = 0.09）和符号数字模态测验（SMD = 0.25；95% CI -0.15 - 0.66；I² 0%；p = 0.21）上的改善在统计学上不显著。
结论
荟萃分析的初步结果不一致，但表明MBI训练对PwMS的认知功能可能有益。需要高质量的RCT来更明确地测试MBIs对PwMS认知功能的影响。
系统评价注册
PROSPERO，标识符CRD42021286429。
Zotero 插件