重复经颅磁刺激对抑郁情绪超过轻度的患者睡眠质量的影响：一项系统评价和荟萃分析。
The effect of repetitive transcranial magnetic stimulation on sleep quality in patients with more than mild depressive mood: a systematic review and meta-analysis.
作者信息
Liu Yu'ang, Huang Silang, Zhang Xinxin, Liao Huangying, Liu Weiguo, Zhang Zhi, Qu Xianhui, Wang Ziwen
机构信息
College of Physical Education and Health, Guangxi Normal University, Guilin, Guangxi, China.
College of Education, Guilin University, Guilin, Guangxi, China.
出版信息
Front Psychiatry. 2025 Feb 6;16:1511930. doi: 10.3389/fpsyt.2025.1511930. eCollection 2025.
BACKGROUND
The purpose of this study was to systematically evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) therapy on sleep quality in patients with more than mild depressive mood.
METHODS
Randomized controlled trials in PubMed, Cochrane Library, Web of Science, Embase, Scopus, and ScienceDirect on rTMS to improve sleep quality in patients with more than mild depressive mood up to September 2023 were searched. A meta-analysis was performed using RevMan 5.4 and Stata 17.0 software.
RESULTS
A total of 11 studies, which involved 548 patients, were included. After rTMS treatment, the effect on sleep quality improvement in patients with more than mild depressive mood was better in the experimental group than in the control group [ = 53%, mean difference (MD) = -2.27, 95%CI = -2.97 to -1.57, < 0.00001]. The results of the subgroup analyses showed that, in terms of stimulation frequency, compared with the 5-Hz and 10-Hz groups, the treatment effect of the 1-Hz group was better ( = 32%, MD = -2.69, 95%CI = -3.78 to -1.60, < 0.00001). In terms of treatment duration, compared with the 2-week and 4-week groups, the group with more than 4 weeks of treatment had better treatment outcomes ( = 0%, MD = -2.81, 95%CI = -3.22 to -2.40, < 0.00001). In terms of whether combination therapy was used or not, compared with the combination therapy group ( = 29%, MD = -1.39, 95%CI = -2.30 to -0.48, = 0.003), the non-combination therapy group had a better treatment effect ( = 0%, MD = -2.93, 95%CI = -3.36 to -2.50, < 0.00001).
CONCLUSION
rTMS significantly improves sleep quality in patients with more than mild depression. Subgroup analyses showed that the group using the 1-Hz stimulation frequency, the group with more than 4 weeks of treatment time, and the group with rTMS alone had better efficacy in treating the sleep quality of patients with more than mild depressive mood using rTMS, with the use of combination treatment or not being the main source of heterogeneity.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/, identifier CRD42023467971.
背景
本研究旨在系统评价重复经颅磁刺激（rTMS）疗法对中重度抑郁情绪患者睡眠质量的疗效。
方法
检索了截至2023年9月在PubMed、Cochrane图书馆、科学网、Embase、Scopus和ScienceDirect上关于rTMS改善中重度抑郁情绪患者睡眠质量的随机对照试验。使用RevMan 5.4和Stata 17.0软件进行荟萃分析。
结果
共纳入11项研究，涉及548例患者。rTMS治疗后，实验组对中重度抑郁情绪患者睡眠质量改善的效果优于对照组[ = 53%，平均差（MD）= -2.27，95%可信区间（CI）= -2.97至-1.57， < 0.00001]。亚组分析结果显示，在刺激频率方面，与5Hz和10Hz组相比，1Hz组的治疗效果更好（ = 32%，MD = -2.69，95%CI = -3.78至-1.60， < 0.00001）。在治疗时长方面，与2周和4周组相比，治疗时间超过4周的组治疗效果更好（ = 0%，MD = -2.81，95%CI = -3.22至-2.40， < 0.00001）。在是否使用联合治疗方面，与联合治疗组（ = 29%，MD = -1.39，95%CI = -2.30至-0.48， = 0.003）相比，非联合治疗组的治疗效果更好（ = 0%，MD = -2.93，95%CI = -3.36至-2.50， < 0.00001）。
结论
rTMS能显著改善中重度抑郁患者的睡眠质量。亚组分析表明，使用1Hz刺激频率的组、治疗时间超过4周的组以及单纯使用rTMS的组在使用rTMS治疗中重度抑郁情绪患者睡眠质量方面疗效更好，联合治疗的使用与否并非异质性的主要来源。
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