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物质使用障碍中脑刺激研究的趋势:对ClinicalTrials.gov注册试验及其出版物的综述

Trends of Brain Stimulation Research in Substance Use Disorder: A Review of ClinicalTrials.gov Registered Trials and Their Publications.

作者信息

Biswas Tathagata, Singh Gaurav Kumar, Mishra Pritiman, Mishra Biswa Ranjan, Parmar Arpit

机构信息

Dept. of Psychiatry, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.

Drug De-Addiction Programme, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.

出版信息

Indian J Psychol Med. 2024 Dec 9:02537176241300195. doi: 10.1177/02537176241300195.

Abstract

PURPOSE OF THE REVIEW

Brain stimulation techniques targeting neuronal pathways are evolving as a novel therapeutic option for substance use disorders. This study aims to provide an overview of the current research landscape on brain stimulation in addiction psychiatry by analyzing data from ClinicalTrials.gov. It intends to describe the global trends in these trials, highlight the findings reported in their publications, and identify the gaps and challenges to guide future research and clinical practice.

COLLECTION AND ANALYSIS OF DATA

The ClinicalTrials.gov was searched on March 1, 2024, using every possible paired combination of different brain stimulation techniques (including transcranial magnetic stimulation/TMS, transcranial direct-current stimulation/tDCS, deep brain stimulation/DBS, and vagal nerve stimulation/VNS) and psychoactive substances. A total of 163 human trials were identified, and their details were extracted into a datasheet. Completed and terminated studies were searched separately for publication data. The extracted data were then analyzed using suitable descriptive statistics.

CONCLUSION

Most research involved TMS, tDCS, and DBS and focused on alcohol, stimulants, opioids, nicotine, and cannabis. No studies addressed sedatives, hypnotics, hallucinogens, psychedelics, and solvents. Wide variations in modulation protocols and neuroanatomical targets reflect the current lack of guidelines or consensus. Incompleteness and updating delays in the study registry raise concerns regarding registration protocols. The published trials report beneficial effects of TMS in nicotine, stimulant, and cannabis users, TMS in alcohol users, and VNS in opioid users.

摘要

综述目的

针对神经元通路的脑刺激技术正在成为物质使用障碍的一种新型治疗选择。本研究旨在通过分析ClinicalTrials.gov的数据,概述成瘾精神病学中脑刺激的当前研究概况。它旨在描述这些试验的全球趋势,突出其出版物中报道的结果,并确定差距和挑战,以指导未来的研究和临床实践。

数据收集与分析

于2024年3月1日在ClinicalTrials.gov上进行搜索,使用不同脑刺激技术(包括经颅磁刺激/TMS、经颅直流电刺激/tDCS、深部脑刺激/DBS和迷走神经刺激/VNS)与精神活性物质的每一种可能的配对组合。共识别出163项人体试验,并将其详细信息提取到数据表中。分别搜索已完成和已终止研究的发表数据。然后使用合适的描述性统计方法对提取的数据进行分析。

结论

大多数研究涉及TMS、tDCS和DBS,且聚焦于酒精、兴奋剂、阿片类药物、尼古丁和大麻。没有研究涉及镇静剂、催眠药、致幻剂、迷幻剂和溶剂。调制方案和神经解剖靶点的广泛差异反映出目前缺乏指南或共识。研究登记的不完整性和更新延迟引发了对注册方案的担忧。已发表的试验报告了TMS对尼古丁、兴奋剂和大麻使用者、TMS对酒精使用者以及VNS对阿片类药物使用者的有益效果。

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