新型非运动和非药物治疗能否改善帕金森病患者的整体认知？一项系统评价和贝叶斯分析。

Do Novel Nonexercise and Nondrug Treatments Improve Global Cognition in Parkinson's Disease Patients? A Systematic Review and Bayesian Analysis.

作者信息

Tang Yingle, He Peikun, Li Yanyi, Ma Guixian, Zhang Yuhu, Wang Lijuan, Nie Kun

机构信息

Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.

Guangzhou key Laboratory of Diagnosis and Treatment for Neurodegenerative Diseases, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.

出版信息

Eur J Neurosci. 2025 Feb;61(3):e70008. doi: 10.1111/ejn.70008.

DOI:10.1111/ejn.70008

PMID:39888085

Abstract

This Bayesian network meta-analysis method was used to assess the effect of novel treatments on global cognition in patients with Parkinson's disease (PD). We searched randomized controlled trials from PubMed, Cochrane Library, Web of Science and Embase to investigate novel treatments for global PD cognition until April 10, 2024. Effect size measures were standardized mean differences with 95% confidence intervals. We included 13 studies investigating traditional paper-and-pencil cognitive training, modified cognitive training (MCT), repetitive transcranial magnetic stimulation (rTMS), rTMS plus MCT, Mediterranean diet, speech therapy, transcranial direct current stimulation (tDCS) and tDCS plus MCT. Comparisons between novel treatments and the control group revealed the following findings: Mediterranean diet (1.25, 0.74-1.76), rTMS plus MCT (0.82, 0.13-1.52), rTMS (0.42, 0.08-0.76) and MCT (0.34, 0.03-0.66) exhibited statistically significant improvements in global cognition in patients with PD, while the remaining treatments did not reveal significant differences. To conclude, the Mediterranean diet, rTMS, MCTs and rTMS plus MCT could effectively improve global cognition in patients with PD.

摘要

本贝叶斯网络荟萃分析方法用于评估新型治疗方法对帕金森病（PD）患者整体认知的影响。我们检索了截至2024年4月10日来自PubMed、Cochrane图书馆、科学网和Embase的随机对照试验，以研究针对PD整体认知的新型治疗方法。效应量测量指标为标准化均数差及95%置信区间。我们纳入了13项研究，这些研究涉及传统的纸笔认知训练、改良认知训练（MCT）、重复经颅磁刺激（rTMS）、rTMS加MCT、地中海饮食、言语治疗、经颅直流电刺激（tDCS）以及tDCS加MCT。新型治疗方法与对照组之间的比较得出以下结果：地中海饮食（1.25，0.74 - 1.76）、rTMS加MCT（0.82，0.13 - 1.52）、rTMS（0.42，0.08 - 0.76）和MCT（0.34，0.03 - 0.66）在PD患者的整体认知方面表现出统计学上的显著改善，而其余治疗方法未显示出显著差异。综上所述，地中海饮食、rTMS、MCT以及rTMS加MCT可有效改善PD患者的整体认知。