Haczkiewicz Michal, Hylén Ulrika, Msghina Mussie
School of Medical Sciences, Örebro University, Örebro, Sweden.
Unit for Clinical Studies, Region Örebro County University Hospital, Örebro, Sweden.
Front Psychiatry. 2025 Jun 3;16:1593211. doi: 10.3389/fpsyt.2025.1593211. eCollection 2025.
The cholinergic system has broad implications for affective and cognitive processes, which makes it pertinent for the psychopathology and treatment of mental disorders. Questions concerning its role in schizophrenia, a chronic disorder characterized by psychosis, emotional blunting and cognitive deficits, have been made particularly relevant due to the recent Food and Drug Administration (FDA) approval of a muscarinic agonist as an antipsychotic agent. The present paper details the protocol for a scoping review that will map models, evidence and research gaps concerning the role of the cholinergic system in the positive, negative and cognitive domains implicated in the psychopathology of schizophrenia.
The scoping review will be conducted according to JBI (formerly the Joanna Briggs institute) methodology, using articles from the following databases: PubMed, Embase, Scopus, Cochrane Central Register of Controlled Trials and PsycInfo. Two independent reviewers will screen the articles using title and abstract, after which full text-analysis will determine inclusion. Only published original peer-reviewed English-language studies from the last 20 years that pertain to the review objective will be included. Clinical studies will be assessed for methodological quality and risk of bias. The results, which the reviewers will extract independently of each other using a data extraction tool, will be presented in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocol Extension for Scoping Reviews (PRISMA-ScR).
Clarifying the research gaps in the field can indicate where future pre-clinical and clinical studies and systematic reviews can be worthwhile, and the risk of bias assessment aids in this by stratifying the included clinical trials according to quality. However, the language and publication date restrictions risk excluding relevant studies, which can introduce bias.
胆碱能系统对情感和认知过程具有广泛影响，这使其与精神障碍的精神病理学及治疗密切相关。鉴于美国食品药品监督管理局（FDA）最近批准一种毒蕈碱激动剂作为抗精神病药物，关于其在精神分裂症（一种以精神病、情感迟钝和认知缺陷为特征的慢性疾病）中作用的问题变得尤为重要。本文详细介绍了一项范围综述的方案，该综述将梳理有关胆碱能系统在精神分裂症精神病理学所涉及的阳性、阴性和认知领域中作用的模型、证据及研究空白。
范围综述将按照JBI（原乔安娜·布里格斯研究所）方法进行，使用来自以下数据库的文章：PubMed、Embase、Scopus、Cochrane对照试验中央注册库和PsycInfo。两名独立评审员将通过标题和摘要筛选文章，之后进行全文分析以确定纳入情况。仅纳入过去20年发表的、与综述目标相关的、经同行评审的英文原创研究。将对临床研究的方法学质量和偏倚风险进行评估。评审员将使用数据提取工具相互独立提取结果，并按照系统评价和Meta分析方案扩展的范围综述的首选报告项目（PRISMA-ScR）进行呈现。
明确该领域的研究空白可指明未来临床前和临床研究以及系统评价可能值得开展的方向，偏倚风险评估通过根据质量对纳入的临床试验进行分层来助力于此。然而，语言和发表日期限制可能会排除相关研究，从而引入偏倚。
