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经颅直流电刺激治疗重度抑郁症的认知效能与安全性:一项系统综述和荟萃分析

Cognitive potency and safety of tDCS treatment for major depressive disorder: a systematic review and meta-analysis.

作者信息

Wang Junjie, Yao Xinru, Ji Yuqi, Li Hong

机构信息

School of Psychology, Capital Normal University, Beijing, China.

Beijing Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing, China.

出版信息

Front Hum Neurosci. 2024 Sep 16;18:1458295. doi: 10.3389/fnhum.2024.1458295. eCollection 2024.

Abstract

BACKGROUND

The benefits of transcranial direct current stimulation (tDCS) for patients with major depression disorders are well-established, however, there is a notable research gap concerning its comprehensive effects on both depressive symptoms and cognitive functions. Existing research is inconclusive regarding the cognitive enhancement effects of tDCS specifically in MDD patients. The present study aims to fill this knowledge gap by scrutinizing the most updated evidence on the effectiveness of tDCS in anti-depressive treatment and its influence on cognitive function.

METHODS

A systematic review was performed from the first date available in PubMed, EMBASE, Cochrane Library, and additional sources published in English from 1 January 2001 to 31 May 2023. We examined cognitive outcomes from randomized, sham-controlled trials of tDCS treatment for major depression. The evaluation process strictly followed the Cochrane bias risk assessment tool into the literature, and meta-analysis was performed according to the Cochrane System Reviewer's Manual.

RESULTS

In this quantitative synthesis, we incorporated data from a total of 371 patients across 12 studies. Results showed significant benefits following active tDCS compared to sham for the antidepressant effect [SMD: -0.77 (-1.44, -0.11)]. Furthermore, active relative to sham tDCS treatment was associated with increased performance gains on a measure of verbal memory [SMD: 0.30 (-0.02, 0.62)]. These results did not indicate any cognitive enhancement after active tDCS relative to sham for global cognitive function, whereas there was a noticeable trend toward statistical significance specifically in the effect of verbal memory.

CONCLUSIONS

Our study offers crucial evidence-based medical support for tDCS in antidepressant and dimension-specific cognitive benefits. Further well-designed, large-scale randomized sham-controlled trials are warranted to further validate these findings.

SYSTEMATIC REVIEW REGISTRATION

https://inplasy.com/, identifier: INPLASY202360008.

摘要

背景

经颅直流电刺激(tDCS)对重度抑郁症患者的益处已得到充分证实,然而,关于其对抑郁症状和认知功能的综合影响,仍存在显著的研究空白。现有研究对于tDCS在重度抑郁症患者中的认知增强作用尚无定论。本研究旨在通过审视tDCS在抗抑郁治疗中的有效性及其对认知功能影响的最新证据,填补这一知识空白。

方法

我们从2001年1月1日至2023年5月31日在PubMed、EMBASE、Cochrane图书馆以及其他英文来源中进行了系统回顾。我们研究了tDCS治疗重度抑郁症的随机、假对照试验的认知结果。评估过程严格遵循Cochrane偏倚风险评估工具对文献进行评估,并根据Cochrane系统评价员手册进行荟萃分析。

结果

在本次定量综合分析中,我们纳入了12项研究中总计371名患者的数据。结果显示,与假刺激相比,主动tDCS在抗抑郁效果方面具有显著益处[标准化均数差:-0.77(-1.44,-0.11)]。此外,与假刺激相比,主动tDCS治疗与言语记忆测量指标上的表现提升相关[标准化均数差:0.30(-0.02,0.62)]。这些结果并未表明主动tDCS相对于假刺激在整体认知功能上有任何认知增强作用,然而,在言语记忆效果方面存在明显的统计学显著性趋势。

结论

我们的研究为tDCS在抗抑郁和特定维度认知益处方面提供了关键的循证医学支持。有必要进行进一步精心设计、大规模的随机假对照试验,以进一步验证这些发现。

系统评价注册

https://inplasy.com/,标识符:INPLASY202360008。

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