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经颅直流电刺激(tDCS)治疗强迫症、创伤后应激障碍和焦虑症的即时和长期疗效:系统评价和荟萃分析。

Immediate and long-term efficacy of transcranial direct current stimulation (tCDS) in obsessive-compulsive disorder, posttraumatic stress disorder and anxiety disorders: a systematic review and meta-analysis.

机构信息

Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, China.

School of Humanities and Social Sciences, Shanxi Medical University, Jinzhong, China.

出版信息

Transl Psychiatry. 2024 Aug 25;14(1):343. doi: 10.1038/s41398-024-03053-0.

Abstract

Currently, there is still debate over the effectiveness of transcranial direct current stimulation (tDCS) in treating obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD) and anxiety disorders (ADs). To investigate the immediate and long-term effectiveness of tDCS in these diseases, we conducted a systematic review and quantitative analysis of existing literature on the treatment of OCD, PTSD, and ADs with tDCS. Following the PRISMA guidelines, we searched seven electronic databases and systematically retrieved articles published from May 2012 to June 2024 that compared the effects of active tDCS with sham stimulation in the treatment of these disorders. We included primary outcome measures such as the change scores in disorder-specific and general anxiety symptoms before and after treatment, as well as secondary outcomes such as changes in disorder-specific and general anxiety symptoms at follow-up. We also assessed the impact of tDCS on depressive symptoms. Fifteen papers met the eligibility criteria. Overall, the results of meta-analysis indicated that tDCS had a high effect in improving specific symptoms (SMD = -0.73, 95% CI: -1.09 to -0.37) and general anxiety symptoms (SMD = -0.75; 95% CI: -1.23 to -0.26) in OCD, PTSD and ADs, with effects lasting up to 1 month and showing a moderate effect size. Furthermore, tDCS demonstrated immediate and significant alleviation of depressive symptoms in these diseases. This study concludes that tDCS can serve as a non-invasive brain stimulation technology for treating these disorders, and the therapeutic effects can be maintained for a period of time.

摘要

目前,对于经颅直流电刺激(tDCS)治疗强迫症(OCD)、创伤后应激障碍(PTSD)和焦虑障碍(ADs)的有效性仍存在争议。为了研究 tDCS 在这些疾病中的即时和长期疗效,我们对 tDCS 治疗 OCD、PTSD 和 AD 的现有文献进行了系统评价和定量分析。我们按照 PRISMA 指南,检索了 7 个电子数据库,并系统地检索了 2012 年 5 月至 2024 年 6 月期间发表的比较主动 tDCS 与假刺激治疗这些疾病的效果的文章。我们纳入了疾病特异性和一般焦虑症状在治疗前后的变化评分等主要结局指标,以及治疗后随访时疾病特异性和一般焦虑症状的变化等次要结局指标。我们还评估了 tDCS 对抑郁症状的影响。符合纳入标准的文献有 15 篇。总体而言,荟萃分析结果表明,tDCS 对改善 OCD、PTSD 和 AD 中的特定症状(SMD=-0.73,95%CI:-1.09 至-0.37)和一般焦虑症状(SMD=-0.75;95%CI:-1.23 至-0.26)具有较高的疗效,疗效可持续长达 1 个月,且具有中等的效应量。此外,tDCS 还能立即显著缓解这些疾病中的抑郁症状。本研究得出结论,tDCS 可以作为治疗这些疾病的一种非侵入性脑刺激技术,且治疗效果可以维持一段时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/faf9/11345433/4a3f6832dab8/41398_2024_3053_Fig1_HTML.jpg

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