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音乐辅助疗法对中风患者抑郁和认知障碍的影响及其对生活质量的影响:系统评价与荟萃分析

Effects of Music-Supported Therapy for Depression and Cognitive Disorders in People Living with Stroke and Its Impact on Quality of Life: A Systematic Evaluation and Meta-Analysis.

作者信息

Wang Zhen, Xue Yingxia, Sun Guiying, Yun Jiajia, Li Yalei, Chen Qi, Wang Ruiwen, Wang Jiahui, Ren Chao

机构信息

Special Education and Rehabilitation College, Binzhou Medical University, Yantai, China.

Department of Rehabilitation, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China.

出版信息

Cerebrovasc Dis. 2025 Jan 6:1-26. doi: 10.1159/000543361.

Abstract

INTRODUCTION

Stroke not only leads to physical dysfunction in people living with stroke, but also causes emotional and cognitive abnormalities, which significantly affect survival and quality of life. Prior research has shown that music-supported therapy (MST) has the ability to improve depression and cognitive performance through stimulation of the central nervous system. Nevertheless, there is a dearth of rigorous systematic assessments of the effectiveness of MST in improving depression and cognitive impairments in people living with stroke, as well as the impact of these benefits on their overall quality of life. This systematic review and meta-analysis aimed to assess the impact of MST on emotional and cognitive impairments in people living with stroke, as well as its influence on their quality of life.

METHODS

The PRISMA 2020 guidelines were followed to search for articles on MST treating depression and cognitive issues in people living with stroke in the PubMed, Embase, Web of Science, Wanfang, CNKI, CSTJ, and SinoMed databases, with a cut-off date of July 11, 2024. Two researchers utilized the revised Cochrane RoB-I risk of bias technique to evaluate the quality of all relevant literature obtained. They subsequently extracted and meta-analyzed the data using Review Manager 5.4.1 software.

RESULTS

Seventy-two studies involving a total of 5,543 people living with stroke were included, and the meta-analysis revealed that MST had a significant effect on depression and cognitive deficits in people living with stroke (SMDHAMD = 1.49, 95% CI: 1.21-1.76, p < 0.001, MDMMSE = 2.53, CI: 1.60-3.45, p < 0.001, MDMoCA = 3.59, CI: 2.57-4.62, p < 0.001), which took effect from 2 weeks of treatment and was accompanied by an increase in serum 5-HT level (SMD5-HT = 2.22, CI: 1.47-2.96, p < 0.001) and improvements in depression and cognitive function, daily living abilities (SMDADL = 1.72, CI: 1.32-2.11, p < 0.001), limb motor function (SMDFMA = 1.25, CI: 0.47-2.02, p < 0.001), and neurological function (SMDNIHSS = -1.77, CI: -2.50 to -1.04, p < 0.001).

CONCLUSION

MST effectively improves depression and cognitive function of people living with a stroke and enhances their ability to perform daily activities and limb motor function. Importantly, improvements in depression and cognitive function occur earlier than those in daily life ability and neurological function. Additionally, the level of serum 5-HT may serve as a potential indicator for assessing the effectiveness of MST.

摘要

引言

中风不仅会导致中风患者出现身体功能障碍,还会引发情绪和认知异常,这对患者的生存和生活质量产生重大影响。先前的研究表明,音乐辅助疗法(MST)能够通过刺激中枢神经系统来改善抑郁和认知表现。然而,目前缺乏对MST改善中风患者抑郁和认知障碍的有效性,以及这些益处对其整体生活质量影响的严格系统评估。本系统评价和荟萃分析旨在评估MST对中风患者情绪和认知障碍的影响及其对生活质量的作用。

方法

遵循PRISMA 2020指南,在PubMed、Embase、Web of Science、万方、中国知网、维普资讯和中国生物医学文献数据库中检索关于MST治疗中风患者抑郁和认知问题的文章,截止日期为2024年7月11日。两名研究人员采用修订后的Cochrane RoB-I偏倚风险技术评估所获所有相关文献的质量。随后,他们使用Review Manager 5.4.1软件提取数据并进行荟萃分析。

结果

纳入72项研究,共涉及5543名中风患者,荟萃分析显示MST对中风患者的抑郁和认知缺陷有显著影响(标准化均数差汉密尔顿抑郁量表=1.49,95%置信区间:1.21-1.76,p<0.001;简易精神状态检查表=2.53,置信区间:1.60-3.45,p<0.001;蒙特利尔认知评估量表=3.59,置信区间:2.57-4.62,p<0.001),从治疗2周起生效,同时血清5-羟色胺水平升高(标准化均数差5-羟色胺=2.22,置信区间:1.47-2.96,p<0.001),抑郁和认知功能、日常生活能力(标准化均数差日常生活活动量表=1.72,置信区间:1.32-2.11,p<0.001)、肢体运动功能(标准化均数差Fugl-Meyer评估量表=1.25,置信区间:0.47-2.02,p<0.001)和神经功能(标准化均数差美国国立卫生研究院卒中量表=-1.77,置信区间:-2.50至-1.04,p<0.001)均有所改善。

结论

MST有效改善中风患者的抑郁和认知功能,提高其日常生活活动能力和肢体运动功能。重要的是,抑郁和认知功能的改善早于日常生活能力和神经功能的改善。此外,血清5-羟色胺水平可能作为评估MST有效性的潜在指标。

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