Safwi Sadia Rehman, Rizvi Abid, Usmani Mohammad Amir, Husain Karrar, Brar Kanwarjeet, Yadava Deep
Yale School of Public Health, New Haven, CT, USA.
Department of Behavioral Medicine and Psychiatry, West Virginia University, USA.
Schizophr Res Cogn. 2024 Oct 23;39:100335. doi: 10.1016/j.scog.2024.100335. eCollection 2025 Mar.
Cognitive impairments in schizophrenia significantly affect functional outcomes and quality of life. This meta-analysis evaluates the effectiveness of transcranial direct current stimulation (tDCS) as an intervention for cognitive deficits in individuals with schizophrenia.
From May 20 to June 15, 2024, a systematic search of PubMed, Medline, Embase, and the Cochrane central register of controlled trials was conducted. After applying eligibility criteria, 13 randomized sham-controlled trials were included, involving 261 participants in the tDCS group and 247 in the sham group. Standardized mean difference (SMD) was computed to measure the effect size of cognitive outcomes. Statistical analyses were performed using a random-effects model to account for heterogeneity.
The pooled analysis yielded an SMD of 0.09 (95 % CI: -0.17 to 0.35), indicating a non-significant difference between tDCS and sham on cognitive outcomes. Moderate heterogeneity (I = 44 %) was observed, attributed to variations in tDCS protocols, participant demographics, and cognitive assessment tools. Although certain studies showed improvements in specific domains like working memory, the overall impact of tDCS on cognitive symptoms was not statistically significant.
This meta-analysis underscores the lack of significant evidence for tDCS in improving cognitive deficits in schizophrenia. The findings highlight the urgent need for standardizing tDCS protocols and employing domain-specific cognitive assessments. This standardization, along with the collection of more domain-specific data, is crucial for future research and the improvement of current methodologies.
精神分裂症中的认知障碍显著影响功能结局和生活质量。本荟萃分析评估经颅直流电刺激(tDCS)作为精神分裂症患者认知缺陷干预措施的有效性。
于2024年5月20日至6月15日,对PubMed、Medline、Embase和Cochrane对照试验中央注册库进行了系统检索。在应用纳入标准后,纳入了13项随机假刺激对照试验,tDCS组有261名参与者,假刺激组有247名参与者。计算标准化均数差(SMD)以衡量认知结局的效应大小。采用随机效应模型进行统计分析以考虑异质性。
汇总分析得出SMD为0.09(95%CI:-0.17至0.35),表明tDCS与假刺激在认知结局方面无显著差异。观察到中度异质性(I² = 44%),这归因于tDCS方案、参与者人口统计学特征和认知评估工具的差异。尽管某些研究显示在工作记忆等特定领域有所改善,但tDCS对认知症状的总体影响在统计学上并不显著。
本荟萃分析强调缺乏tDCS改善精神分裂症认知缺陷的显著证据。研究结果凸显了标准化tDCS方案和采用特定领域认知评估的迫切需求。这种标准化以及收集更多特定领域的数据对于未来研究和当前方法的改进至关重要。