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东莨菪碱对记忆和注意力的影响:一项系统评价与荟萃分析。

The effect of scopolamine on memory and attention: a systematic review and meta-analysis.

作者信息

Miravalles Cerena, Cannon Dara M, Hallahan Brian

机构信息

Clinical Research Facility, University of Galway, Galway, Ireland.

Clinical Neuroimaging Laboratory, Centre for Neuroimaging and Cognitive Genomics, Galway Neuroscience Centre, College of Medicine, Nursing & Health Sciences, University of Galway, Galway, Ireland.

出版信息

Eur Psychiatry. 2025 Apr 8;68(1):e50. doi: 10.1192/j.eurpsy.2025.2446.

Abstract

BACKGROUND

Scopolamine is a muscarinic receptor antagonist and is widely utilized as a "memory-loss model." However, its impact across different memory and attention tasks and using different modes of administration has yet to be clearly evaluated. This systematic review and meta-analysis investigates the effect of scopolamine, across all routes of administration and across different dosages, on memory and attention performance in healthy humans (PROSPERO ID: CRD42024531634).

METHODS

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched (on 20 April 2024) for studies that utilized scopolamine and assessed memory and/or attention. Random-effects meta-analyses were conducted across a range of memory and attention tasks using "Comprehensive Meta-Analysis," Version 3, to evaluate differential pharmacological effects on cognitive tasks between the scopolamine and placebo groups.

RESULTS

Forty-six studies fulfilled the inclusion and exclusion criteria. Scopolamine negatively impaired performance on all memory tasks (immediate memory, delayed recall, digit span, Buschke selective reminding task, and recognition memory) and led to slower reaction times for three of the five attention tasks examined (choice reaction time, simple reaction time, and rapid visual information processing) compared to placebo. Scopolamine's negative effect on memory and attention was greater with injectable (e.g., intramuscular, intravenous, and subcutaneous) compared to non-injectable routes of administration (e.g., intranasal, oral, and transdermal).

CONCLUSION

This study supports the use of scopolamine as a "memory-loss model," particularly when given by an injectable route of administration. Future clinical trials should evaluate the bioavailability of scopolamine across different routes of administration to ensure therapeutic benefits outweigh any potential adverse cognitive effects.

摘要

背景

东莨菪碱是一种毒蕈碱受体拮抗剂,被广泛用作“记忆丧失模型”。然而,其在不同记忆和注意力任务以及不同给药方式下的影响尚未得到明确评估。本系统评价和荟萃分析研究了东莨菪碱在所有给药途径和不同剂量下对健康人记忆和注意力表现的影响(国际前瞻性系统评价注册编号:CRD42024531634)。

方法

按照系统评价和荟萃分析的首选报告项目指南,我们(于2024年4月20日)搜索了使用东莨菪碱并评估记忆和/或注意力的研究。使用“综合荟萃分析”第3版对一系列记忆和注意力任务进行随机效应荟萃分析,以评估东莨菪碱组和安慰剂组对认知任务的不同药理作用。

结果

46项研究符合纳入和排除标准。与安慰剂相比,东莨菪碱对所有记忆任务(即时记忆、延迟回忆、数字广度、布希克选择性提醒任务和识别记忆)的表现均有负面影响,并导致所检查的五项注意力任务中的三项(选择反应时间、简单反应时间和快速视觉信息处理)反应时间变慢。与非注射给药途径(如鼻内、口服和透皮)相比,注射给药(如肌肉内、静脉内和皮下)时东莨菪碱对记忆和注意力的负面影响更大。

结论

本研究支持将东莨菪碱用作“记忆丧失模型”,尤其是通过注射给药途径时。未来的临床试验应评估东莨菪碱在不同给药途径下的生物利用度,以确保治疗益处超过任何潜在的不良认知影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e697/12041729/0ebd27d61c93/S0924933825024460_fig1.jpg

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