Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China.
The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230032, China.
J Psychiatr Res. 2024 Oct;178:378-387. doi: 10.1016/j.jpsychires.2024.07.046. Epub 2024 Jul 31.
Non-invasive brain stimulation (NIBS), including repetitive transcranial magnetic stimulation (rTMS), continuous theta-burst stimulation (cTBS), and transcranial direct current stimulation (tDCS), is an emerging intervention that has been used to treat various mental illnesses. However, previous studies have not comprehensively compared the efficacies of various NIBS modalities in alleviating anxiety symptoms among patients with generalized anxiety disorder (GAD). Therefore, this study conducted a systematic review and meta-analysis to assess the efficacy of NIBS for patients with GAD.
A systematic search of four major bibliographic databases (Embase, PubMed, Web of Science and The Cochrane Library) was conducted from inception dates to November 26, 2023 to identify eligible studies. The data were analyzed using a random-effects model.
Seven randomized controlled trials (RCTs) were included in the meta-analysis. Significant differences were found in changes in Hamilton anxiety rating scale (HARS) scores, study-defined response, and remission between the intervention and control groups. Moreover, the intervention groups experienced a significantly higher frequency of headaches.
The results revealed that interventions improved GAD compared to control groups. cTBS and rTMS exhibited better treatment efficacy than tDCS, which did not appear to have a significant therapeutic effect. Longer follow-up periods and larger sample sizes are required in future RCTs.
This meta-analysis was conducted in accordance with PRISMA guidelines and registered at PROSPERO (https://www.crd.york.ac.uk/PROSPERO/, CRD42023466285).
非侵入性脑刺激（NIBS），包括重复经颅磁刺激（rTMS）、连续 theta 爆发刺激（cTBS）和经颅直流电刺激（tDCS），是一种新兴的干预手段，已被用于治疗各种精神疾病。然而，以前的研究并没有全面比较各种 NIBS 模式在缓解广泛性焦虑症（GAD）患者焦虑症状方面的疗效。因此，本研究进行了系统评价和荟萃分析，以评估 NIBS 对 GAD 患者的疗效。
从各数据库建立日期到 2023 年 11 月 26 日，系统检索了 Embase、PubMed、Web of Science 和 The Cochrane Library 这四个主要数据库，以确定符合条件的研究。使用随机效应模型进行数据分析。
荟萃分析纳入了 7 项随机对照试验（RCT）。干预组与对照组在汉密尔顿焦虑量表（HARS）评分、研究定义的反应和缓解方面的变化存在显著差异。此外，干预组头痛的发生频率明显更高。
结果表明，与对照组相比，干预措施改善了 GAD。cTBS 和 rTMS 的治疗效果优于 tDCS，后者似乎没有显著的治疗效果。未来的 RCT 需要更长的随访时间和更大的样本量。
本荟萃分析按照 PRISMA 指南进行，并在 PROSPERO（https://www.crd.york.ac.uk/PROSPERO/，CRD42023466285）上进行了注册。
