He Yue, Ming Wei, Tan Yinhu, Wang Yang, Wang Mengyao, Li Hang, Jiao Zhenzhu, Hou Yao
School of Nursing, Changchun University of Chinese Medicine, Changchun, Jilin, China.
Department of Orthopedics, The Third Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, Jilin, China.
Medicine (Baltimore). 2025 Jul 25;104(30):e43597. doi: 10.1097/MD.0000000000043597.
Motor neuron disease (MND) is a neurodegenerative disorder that causes progressive loss of motor function. With limited disease-modifying drug therapies, cognitive behavioral therapy (CBT) has emerged as a key nonpharmacological intervention. This systematic review evaluated CBT's therapeutic potential across clinical domains to inform psychosocial care of patients with MND.
Comprehensive searches were performed in PubMed, Web of Science, Cochrane Library, and Embase, from inception until February 2025. Two researchers independently screened the literature, extracted data, assessed study quality, and resolved disagreements via consensus or third-party consultation.
Five studies involving 561 patients were included. Compared with conventional care, CBT significantly improves patients' quality of life and psychological flexibility. However, the effects on caregiver burden and physical health were not statistically significant. CBT modalities included acceptance and commitment therapy, dialectical behavior therapy, rational-emotive behavior therapy, mindfulness cognitive therapy, and metacognitive training. Traditional CBT demonstrated superior efficacy in reducing anxiety and depression compared to acceptance and commitment therapy.
CBT effectively enhances psychological flexibility and quality of life and reduces anxiety and depression in patients with MND. The standardization of outcome measures requires improvement. High-quality randomized controlled trials are needed to further assess CBT's impact of CBT on caregiver burden and patients' physical health.
运动神经元病（MND）是一种神经退行性疾病，会导致运动功能逐渐丧失。由于疾病修饰药物疗法有限，认知行为疗法（CBT）已成为一种关键的非药物干预措施。本系统评价评估了CBT在各个临床领域的治疗潜力，以为MND患者的心理社会护理提供参考。
从创刊至2025年2月，在PubMed、科学网、Cochrane图书馆和Embase中进行了全面检索。两名研究人员独立筛选文献、提取数据、评估研究质量，并通过共识或第三方咨询解决分歧。
纳入了5项研究，共561名患者。与传统护理相比，CBT显著改善了患者的生活质量和心理灵活性。然而，对照顾者负担和身体健康的影响无统计学意义。CBT模式包括接受与承诺疗法、辩证行为疗法、理性情绪行为疗法、正念认知疗法和元认知训练。与接受与承诺疗法相比，传统CBT在减轻焦虑和抑郁方面显示出更高的疗效。
CBT有效提高了MND患者的心理灵活性和生活质量，并减轻了焦虑和抑郁。结局指标的标准化需要改进。需要高质量的随机对照试验来进一步评估CBT对照顾者负担和患者身体健康的影响。
