Giustiniani Andreina, Maistrello Lorenza, Mologni Valentina, Danesin Laura, Burgio Francesca
Neuropsychology Department, IRCCS San Camillo Hospital, Via Alberoni 70, 30126, Venice, Italy.
IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy.
Neurol Sci. 2025 Feb;46(2):579-592. doi: 10.1007/s10072-024-07778-0. Epub 2024 Sep 25.
Cognitive deficits are common nonmotor symptoms in Parkinson's disease (PD). Non-Invasive Brain Stimulation (NIBS) could be a potential aid to prevent or delay dementia progression in this clinical population. However, previous studies reported controversial results concerning their efficacy on cognitive symptoms of PD. Hence, the present meta-analysis aims to systematically examine the effects of NIBS as possible treatments for PD cognitive impairments. Understanding NIBS' impact on these symptoms may be of outstanding importance to implement new therapeutic strategies and improve the patients' quality of life.
EMBASE, Scopus, and PubMed databases were systematically searched for consecutive studies published from 2000 to March 2023 describing Randomized Controlled Trials studies evaluating the effect of NIBS on PD cognitive symptoms. From the included studies, data concerning neuropsychological tests were extracted and grouped into six cognitive domains, separately analyzed. Hedge's method was computed as the effect size measure of the extracted data; heterogeneity among studies and publication bias were also assessed. The Cochrane's RoB2 tool was used to evaluate the risk of bias for each of the included studies.
After database searching and screening of texts, sixteen studies met the inclusion criteria. No significant results emerged from any investigated cognitive domain when comparing NIBS and sham treatments.
Several factors may have contributed to the lack of effects; among these, methodological choices, the small sample of studies, the high heterogeneity of data and stimulation protocols pose the need for more controlled studies to highlight the potentiality of NIBS as a future treatment for PD cognitive impairments.
认知缺陷是帕金森病（PD）常见的非运动症状。非侵入性脑刺激（NIBS）可能有助于预防或延缓该临床群体的痴呆进展。然而，先前的研究报告了其对PD认知症状疗效的争议性结果。因此，本荟萃分析旨在系统研究NIBS作为PD认知障碍可能治疗方法的效果。了解NIBS对这些症状的影响对于实施新的治疗策略和提高患者生活质量可能至关重要。
系统检索EMBASE、Scopus和PubMed数据库，查找2000年至2023年3月发表的描述评估NIBS对PD认知症状影响的随机对照试验的连续研究。从纳入的研究中，提取有关神经心理学测试的数据，并将其分组到六个认知领域，分别进行分析。计算Hedge方法作为提取数据的效应量指标；还评估了研究之间的异质性和发表偏倚。使用Cochrane的RoB2工具评估每个纳入研究的偏倚风险。
在数据库检索和文本筛选后，16项研究符合纳入标准。比较NIBS和假治疗时，任何调查的认知领域均未出现显著结果。
几个因素可能导致了缺乏效果；其中，方法学选择、研究样本量小、数据和刺激方案的高度异质性表明需要更多对照研究来突出NIBS作为未来PD认知障碍治疗方法的潜力。
